A 63-year-old woman complained of rectal bleeding of hemorroidal type and spontaneous emission of mucus in the feces for 2 months. Laboratory tests, tumoral markers included, were normal. A colonoscopy was performed revealing a 2-cm polypoid lesion ( Fig. 1A) with a mucoid and gelatinous material ( Fig. 2) coming out of it. Cytology and biopsies were inconclusive. An endoscopic ultrasonogram showed a cystic anechoic 20-mm lesion filled with some non-solid materials located in the submucosal layer of the rectal wall (Fig. 1B), without adjacent adenopathies, and a hypertonic internal anal sphincter. Histology showed mucosal thickening with dilated glands and the presence of inflammatory infiltrates, muscular fibers, and congestive vessels in the muscularis propria, findings that can be seen in rectal prolapse. These results, in addition to endoscopic and ultrasonographic findings, established the diagnosis.
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