On colonoscopy, the macroscopic aspect of a lesion is an important criterio
n for the differential diagnosis. We present a case of an apparently malign
ant tumor in the sigmoid. Histological investigation failed to support the
diagnosis made from the gross appearance seen on colonoscopy. After surgica
l resection, the lesion turned out to be a reactive pseudotumor caused by f
ibroepithelial hyperplasia related to a severe diverticulitis with perforat
ion of the intestinal wall.