False-negative endoscopic biopsy of colonic adenocarcinoma in a young man

A 26-year-old man presented with intermittent bright red blood per rectum. His physical examination was unremarkable; however, because microcytic anemia was noted, the patient underwent colonoscopy. A large ascending colonic lesion was noted, a biopsy of which was negative for cancer. Nevertheless, the patient underwent a radical hemicolectomy. Adenocarcinoma of the cecum was found. This case report is an example of a false-negative endoscopic-directed biopsy. A review of recorded video-endoscopy assisted the family physician in appropriate management.