Metachoronous multiple carcinoma in the stoma is condition after abdominoperineal resection, and only 26 cases have been reported in Japan. We report a 67-year-old man with a second tumor in the stoma 15 years after abdominoperineal resection for rectal cancer. The patient reported constipation and increasing tumor size in the stoma 20 years after surgery. A biopsy revealed adenocarcinoma at the stomal site. The patient was diagnosed as having adenocarcinoma at the colostomy site with concomitant gastric cancer, necessitating en block resection of the sigmoid colon and colostomy site with reconstruction of a colostomy in the transverse colon and distal gastrectomy. Histopathological examination showed adenocarcinoma in the stoma invading to the adjacent skin and the muscle with adenocarcinoma of the stomach.
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