SummaryApparently this is the first report of an adenocarcinoma of an ileal stoma. It occurred 19 years after partial colectomy performed for ulcerative colitis. The symptoms and radiographic findings were interpreted to indicate “ileitis.” The tumor continued to grow after limited excision, and the patient died ten months postoperatively.Ileoscopy will help in making a correct diagnosis. Radical excision of the abdominal wall and small bowel and reconstruction of the ileostomy in another quadrant of the abdominal wall is the appropriate treatment for this unusual condition.