A 37-year-old woman was referred by her gynecologist for evaluation of a newly discovered rectal mass. She reported difficulty moving her bowels and a pelvic heaviness, “like a ball in her pelvis.” This sensation was relieved by defecation. She had no blood throughout the rectum. Earlier in the year she was evaluated for infertility and diagnosed with uterine fibroid tumors. She was taken to the operating room for excision of the fibroids. Intraoperatively, a large, fixed mass was discovered in her pelvis between the rectum and the vagina. No biopsies were taken during the procedure. Her medical history was not contributory. She had no family history of colorectal cancer. Results of abdominal examination were unremarkable. Digital rectal examination revealed a fixed mass in the anterior rectum approximately 7 cm from the anal verge.