Abstract
Bladder cancer (BC), one of the urothelial carcinoma (UC) and colorectal cancer (CRC) are Lynch syndrome's manifestations. In this case report, a 56 years old woman was admitted to ER with intermittent, progressive and colicky abdominal pain for 6 months associated with a change in bowel habit and bleeding per rectum, anorexia and weight loss. Rectal examination revealed a nodular, easy to bleed mass from anal verge. MRI revealed left ectopic pelvic kidney with soft tissue enhancing lesion in the lower calyx. Patient was underwent low anterior resection and left nephrectomy after which she was decided to complete on adjuvant XRT and chemotherapy. The comorbidity of UC and CRC in this patient in spite of being of low risky group being a non-smoker female has strongly prove the existence of the lynch syndrome and may replace the molecular confirmation. Therefore genetic investigation of all her relatives for presence of causative genetic abnormalities is mandatory, a project we are currently working on to enable proper medical intervention in the proper time.