Rectosigmoid mass polypoidal mass lesions in an elderly gentleman should always raise the possibility of a colonic neoplasm.

Histopathology following colonoscopy revealed glands of varying sizes in the polyp; the glands are closely packed together, lined by tall cells with hyperchromatic nuclei, and with cytoplasm showing vacuolations. The histology also showed a good number of inflammatory cells, favoring a tubulovillous adenomatous polyp with high-grade dysplasia.