Abstract
INTRODUCTION: Adenosquamous carcinoma (ASC) of the colon is an exceedingly rare and aggressive subtype, with limited data available on long-term survival, particularly among patients with ulcerative colitis (UC). CASE PRESENTATION: We present a 39-year-old male with a 9-year history of UC who experienced severe anemia and hematochezia. Imaging and histopathological analysis confirmed a diagnosis of stage IIIB ASC of the right colon. The patient underwent total colectomy followed by adjuvant chemotherapy (XELOX), ileoanal pouch reconstruction, and stoma closure. After 56 months of follow-up, he remains disease-free with good pouch function. CONCLUSION: This case underscores the prognosis and the need for further research in UC-ASC subtype.