Solitary rectal ulcer syndrome (SRUS) is a rare benign rectal disorder, with an estimated prevalence of one in 100,000 individuals annually.Due to its rare occurrence, it is not adequately diag-nosed and treated, which makes it often misdiagnosed with other diseases such as inflammatory bowel disease (IBD), constipation, and malignancies. Therefore, it is necessary to know its diagnostic features and treatment

This report presents a case of a polypoid solitary rectal ulcer in a 19-year-old man who came to the gastroenterologyclinic with rectal bleeding and chronic constipation, the diagnostic procedures to rule out other critical differential diagnoses, and the treatments performed.It revealed one large semi-circumferential infiltrative mass lesion with a polypoid appearance in the rectum within 5 cm of the anal verge, which was suspected to be malignant, so biopsy was taken .Histopathological study revealed features of solitary rectal ulcer, including fibrosis and extension of smooth muscle fibers in the lamina propria with diamond-shaped crypts, crypt regenerative hyperplasia, surface erosion, crypt hyperplasia, ectatic capillaries, and minimal inflammation. These histologic features and colonoscopy findings were suggestive of polypoid solitary rectal ulcer.

In conclusion, for patients with complaints of rectal bleeding with constipation and the presence of a suspi-cious mass in colonoscopy, a biopsy should be taken to decide on a treatment plan, because it differs based on the nature of the mass. Histological features such as fi-bromuscular obliteration in the lamina propria is in favor of SRUS; however, IBD and malignancies should be ruled out