The sign of Leser-Trélat, the sudden appearance of multiple seborrheic keratoses in conjunction with an internal malignancy, is very uncommon. A case involving a patient who had undergone resection of an adenocarcinoma of the sigmoid colon followed ten years later by the development of an adenocarcinoma of the stomach with exhibition of the sign of Leser-Trélat is presented. A summary of reported cases, along with a discussion of the sign, is provided. This is the first reported case of a patient presenting with the sign of Leser-Trélat along with a second primary malignancy.