A case of obstructing colon cancer is described in a 31-year-old patient affected by hereditary multiple exostoses. The association of these two rare conditions, which has never been described previously, and their early onset prompt us to discuss the clinical and genetic elements of a potential common pathogenic scenario. J. Surg. Oncol. 2009:100:520-522 (C) 2009 Wiley-Liss, Inc.