A 55-year-old woman presented at our hospital with melena. Colonoscopic examination showed a circumferential Type 3 tumor in the ascending colon, and extramural invasion in the anterior wall of the rectum. Contrast-enhanced CT showed wall thickening in the ascending colon and peritoneal metastasis in Douglas's pouch. The peritoneal metastasis invaded the rectum and uterus. Multiple para-aortic lymph nodes located more caudally than the left renal vein were swollen and were suspected of lymph node metastasis. In February 2004, right hemicolectomy plus D3 lymph node dissection, low anterior resection, small bowel resection, hysterectomy including resection of the anterior wall of the vagina, right salpingo-oophorectomy, and para-aortic lymph nodes dissection were performed. Histopathological examination showed moderately differentiated tubular adenocarcinoma, pT4b (intestine, abdominal wall), pN1, P2, H0, M1b (para-aortic lymph nodes, peritoneum), Stage IV, Cur B. As adjuvant chemotherapy, 5-FU plus leucovorin for 6 months followed by UFT plus leucovorin for 2 years were administered. As of July 2014, the patient has survived ten years without recurrence.