Synchronous occurrence of adenocarcinoma and mucosa associated lymphoid tissue(MALT) lymphoma of colon is rare,and its presence with coexisting tuberculosis is still rarer.To our knowledge,this may be the first case report.In the present report,we describe a 43-year-old female who presented with a history of abdominal pain,fever,loss of weight and loss of appetite.Colonoscopy showed a large ulceroproliferative mass arising from the caecum,biopsy of which showed it to be adenocarcinoma of the colon.A right hemicolectomy was performed and microscopic study of the colon revealed tuberculosis and synchronous adenocarcinoma with lymphoma.Eight of sixteen lymph nodes showed tuberculosis and three of sixteenpericoloniclymphnodes showed metastatic deposits.Immunostains further confirmed the tumour to be adenocarcinoma with MALT lymphoma.We would like to highlight the diagnostic challenges arising from the multi-faceted presentations of these three conditions. Synchronous occurrence of adenocarcinoma and mucosa associated lymphoid tissue (MALT) lymphoma of colon is rare, and its presence with coexisting tuberculosis is still rarer. To our knowledge, this may be the first case report. In the present report, we describe a 43- year-old female who presented with a history of abdominal pain, fever, loss of weight and loss of appetite. Colonoscopy showed a large ulceroproliferative mass arising from the caecum, biopsy of which showed it to be adenocarcinoma of the colon. A right hemicolectomy was performed and microscopic study of the colon revealed tuberculosis and synchronous adenocarcinoma with lymphoma. Light of sixteen lymph nodes showed tuberculosis and three of sixteen pericoloniclymphnodes showed metastatic deposits. Immunostains further confirmed the tumor to be adenocarcinoma with MALT lymphoma. We would like to highlight the diagnostic challenges arising from the multi-faceted presentations of these three conditions.