Carcinoma developing at the colostomy site following an abdominoperineal resection (APR) is an extremely rare event, with only a small number of instances documented in the available literature. In the absence of biopsy confirmation, such growths can often be mistaken for conditions such as hyperplasia or granulation tissue, especially at the stoma edges, complicating the diagnosis. We describe a unique case of a man in his late 50s who underwent an abdominoperineal resection due to rectal cancer and, 12 years later, presented with a growth at his colostomy site, with no evidence of metastasis. As there were no distant metastases, segmental resection of the colon, including a 2 cm skin margin, along with a colostomy revision, was performed, followed by a plan for adjuvant treatment. Although tumors at colostomy sites are infrequent, regular and thorough examination of the stoma during follow-up is essential, and early biopsy and colonoscopy should be considered when suspicious growths appear. For these types of cases, segmental colonic resection with an adequate margin and subsequent adjuvant therapy is considered the most effective approach.
