A 26-year-old man presented with intermittent bright red blood per rec
tum. His physical examination was unremarkable; however, because micro
cytic anemia was noted, the patient underwent colonoscopy. A large asc
ending colonic lesion was noted, a biopsy of which was negative for ca
ncer. Nevertheless, the patient underwent a radical hemicolectomy. Ade
nocarcinoma of the cecum was found. This case report is an example of
a false-negative endoscopic-directed biopsy. A review of recorded vide
oendoscopy assisted the family physician in appropriate management.