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A 49-year-old woman had a rectal lesion detected during a screening colonoscopy and was referred to our institution for further evaluation. Her medical history included cervical intraepithelial neoplasia and a family history of breast cancer in her mother. Laboratory tests and tumour markers were within normal limits, including carcinoembryonic antigen (2.0 ng/mL) and carbohydrate antigen 19–9 (2.9 U/mL). Abdominal CT revealed no masses or lymphadenopathy.