Research on carcinogenesis is growing, possible correlation between cancer and other chronic illness is slowly being unveiled. Tuberculosis, one of the commonly occurring chronic granulomatous inflammation is considered asa risk factor for development of malignancy. The pathophysiology and practical implications of their co-existence have received little attention. We present a case of elderly male, who was treated with antitubercular drugs thirty years ago for pulmonary tuberculosis. Recently patient presented with pain in the abdomen and loss of weight. Endoscopy of gastrointestinal tract showed ulceroproliferative growth involving pyloric region of the stomach with antral thickening. Cut section showing grey white growth with two adjacent ulcers. Gross examination of liver showed grey brown lobular mass in segment eight. Lymph node metastasis was seen in lesser and greater omentum. Special stains Mucicarmine&Alcian blue were positive but ZN stain for AFB was negative. Pathologist needs to be aware of the coexistence of Koch’s and malignancy as an uncommon event, maintaining a high index of suspicion for simultaneous and/or misleading presentations. Tuberculosis infection present in immunocompromised patient is well known. Present case highlights occurrence of tuberculous infection in the liver coexisting with gastric adenocarcinoma.