An ulcerated, friable mass was found on endoscopy in the upper rectum along with a polyp in a 21 year old gentleman. Polypectomy was performed. The biopsy of the mass and polyp showed SRUS and infiltrating colorectal adenocarcinoma, respectively. A repeat biopsy from the mass after one week revealed an infiltrating colorectal adenocarcinoma with signet cells instead of SRUS. He had uneventful recovery from high anterior resection and chemotherapy. (Top) Photomicrograph of first biopsy showing rectal glands separated by splaying smooth muscle fibers and fibrosis (arrows). H&E x 20. (Bottom) Photomicrograph of the second biopsy showing normal large bowel mucosa on the left (↑), mucinous areas on the right (→) and signet areas in the center (↓). H&E x 10.