Abstract
Colorectal cancer screening guidelines typically focus on familial history and age-related risk factors, yet Café-au-lait macules could serve as early indicators for tailored surveillance protocols. This case underscores the importance of considering extracolonic manifestations in young patients presenting with colorectal symptoms. We present a case of a young patient with café-au-lait spots who was diagnosed with rectal tubulo-villous dysplastic adenoma following rectal bleeding.