A rectal neuroendocrine tumor in a patient with Crohn's disease: a case report and literature review

Clin J Gastroenterol. 2020 Jun;13(3):320-327. doi: 10.1007/s12328-019-01063-w. Epub 2019 Nov 8.

Abstract

Crohn's disease is recognized to increase the risk of gastrointestinal malignances. Adenocarcinoma is the most common malignancy in these patients. Association between Crohn's disease and adenocarcinoma in the small intestine has already been established, however, the association between neuroendocrine tumor and Crohn's disease remains uncertain. We report a 39-year-old man with Crohn's disease, who was diagnosed with NET in the rectum. He had suffered from fever and anal pain due to the anal fistula and abscess. The disease state was considered to be resistant to medical treatment. He underwent total proctocolectomy, small bowel resection, anal fistula drainage with ileostomy. Postoperative histology revealed a neuroendocrine tumor in the rectum. His postoperative course was uneventful, and he followed a good course under treatment with infliximab and mercaptopurine hydrate. This case highlights the need of careful observation of resected specimens in light of the possibility of NET, especially those with anal disorders.

Keywords: Crohn’s disease; Inflammatory bowel disease; Neuroendocrine tumor.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Colonoscopy
  • Crohn Disease / complications*
  • Humans
  • Male
  • Neuroendocrine Tumors / diagnostic imaging
  • Neuroendocrine Tumors / etiology*
  • Neuroendocrine Tumors / pathology
  • Radiography
  • Rectal Fistula / etiology
  • Rectal Neoplasms / diagnostic imaging
  • Rectal Neoplasms / etiology*
  • Rectal Neoplasms / pathology
  • Rectum / pathology
  • Tomography, X-Ray Computed