The authors base their observations on 3 cases of synchronous carcinoma of the large intestine and 1 case of association of cancer on polyps and synchronous colorectal carcinoma. After a short review of the etiopathogenetic and diagnostic aspects, they focus attention in particular on the various types on surgical approach which synchronous carcinoma of the large intestine offer to surgeons. The authors underline that numerous forms of surgery exist which are often complex and difficult, especially if multiple neoplasia involve separate colic segments and above all if they affect the distal rectal section. In conclusion, they affirm that the association of cancer on polyps and synchronous colorectal carcinoma is not rare and should be treated using combined endoscopic and surgical therapy. To the precise colic exeresis should be followed by endoscopic resection in the case of a scissil, villous polyps with high non-differentiated neoplastic tissue laying close on the endoscopic plane of section.