This is the view on colonoscopy of an adenocarcinoma of the colon. This is a bulky mass which spreads over the colonic mucosal surface. It has surface areas that appear red because it is bleeding, and this led to a positive occult blood in stool which was the screening method for detection. Neoplasms may not maintain the structure of normal tissues, so there is often irregular growth with necrosis and hemorrhage, particularly in larger and more aggressive neoplasms.