A 58-year-old man presented with diarrhea. An incidental rectal mass was discovered, demonstrating endoscopic, sonographic (Fig. 1), magnetic resonance imaging (MRI; Fig. 2), and cytopathologic findings of colitis cystica profunda (CCP), a benign lesion of the colon and rectum [1, 2]; malignancy could not be definitively ruled out, so the patient underwent surgical resection, with histopathology confirming CCP (Fig. 3). Our case highlights the importance of considering CCP in the differential diagnosis of rectal masses that mimic malignancy [3]. Surgical resection removes the mass along with diagnostic uncertainty, but shared decision-making is needed prior to proceeding with a major surgery with associated morbidity and mortality for a benign cause.
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