Natural orifice specimen extraction surgery (NOSES) avoids an auxiliary abdominal incision, but transrectal retrieval is technically demanding in a male patient with right-sided colon cancer and a synchronous upper-abdominal neoplasm. A 59-year-old man presented with hematochezia for more than one month. Colonoscopy showed a circumferential lesion near the hepatic flexure, and biopsy indicated moderately differentiated adenocarcinoma. Contrast-enhanced computed tomography also revealed a 3.2 cm×2.3 cm exophytic mass at the greater curvature of the stomach. Totally laparoscopic gastric wedge resection and radical right hemicolectomy with intracorporeal ileocolic anastomosis were performed. Both protected specimens were retrieved stepwise through a rectal incision. The operative time was 136 min, and blood loss was approximately 20 mL. Pathology demonstrated pT4aN0 colon adenocarcinoma (0/32 lymph nodes) and a low-risk gastric gastrointestinal stromal tumor. The patient was discharged on postoperative day 5 and had normal anal function at the three-month follow-up. This case supports the technical feasibility of synchronous resection with transrectal specimen extraction after strict assessment of specimen size and extraction route; broader indications and long-term safety require further evidence.