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Heterotopic gastric mucosa is an extremely rare condition; in the anorectal region only a very few cases were described up to now. The authors report a case of a 46-year-old woman, asymptomatic, to whom a massive recess was discovered in the rectum, at 12 cm of the anal verge; a bottom flat lesion with 1.5 cm of diameter revealed a focus of normal appearing fundic-type gastric mucosa at histology.