A 95-year-old male presented with a 3-month history of rectal bleeding associated with pain and weight loss. A rectal mass was palpated on examination. His past medical history is significant for ischaemic heart disease, heart failure, chronic obstructive airways disease, and rheumatoid arthritis on low-dose methotrexate. Sigmoidoscopy revealed a large, infiltrative, non-circumferential tumour with contact bleeding on the left lateral rectal wall (Figs. 1 and 2).
