With a mid rectal occupying lesion, consider a rectal tumor with a soft tissue nodular shadow seen posterior to it, which may be a lymph node metastasis. Occupying lesion in the middle rectum is mostly considered as the possibility of rectal cancer, which can be confirmed by history, further physical examination and endoscopy. Posterior soft tissue nodular shadow may be lymph node enlargement appearing from lymphatic metastasis. The main spreading pathway of rectal cancer is lymphatic metastasis, and mesorectal cancer can metastasize upward, downward, sideways and other multiple sites. If the patient has blood in stool, frequent stools, thinning stools, etc., and a rectal mass is found through rectal palpation, it can be initially judged by the naked eye through endoscopy, and at the same time, biopsy can be taken for pathological examination. Middle rectum occupation, it is recommended that further detailed examination to confirm the diagnosis and timely treatment.