Most often colorectal carcinoma occurs single; synchronous multiple carcinomas usually develop at widely disparate sites. We report the case of a 75-year-old male, accusing rectal bleeding, disturbances in bowel transit and weight loss. The rectoscopy examination revealed a fungating, bleeding tumor located 5 cm from anal verge. Pathological diagnostic of the endo-biopsy was ulcerated moderate differentiated adenocarcinoma. Patient underwent surgical amputation of the rectum with lymphadenectomy. Microscopical examination of the surgical specimens confirmed the presence of the adenocarcinoma adjacent to a squamous cell carcinoma, moderate differentiated, with reduced keratinization, infiltrative. Also, 2 from the 7 lymph nodes presented squamous cell carcinoma metastases. The most important differential diagnostic is a rectal adenosquamous carcinoma. Prognostic depends on stage of the disease, generally being worse than of the corresponding adenocarcinoma, and can be improved by radio- and chemotherapy.