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This is the first case report of a primary, pure squamous-cell carcinoma of the small bowel. Small bowel cancer represents only 1 to 2 percent of all gastrointestinal malignancies. Over 35 different histologic types of small bowel tumors have been described. By far, most small bowel epithelial tumors are metastatic. A 65-year-old white female presented with abdominal pain, melena, and hematochezia and was found to have a 5.5-cm, ulcerated, well-differentiated, keratinizing, squamous-cell carcinoma of the terminal ileum.