Colonic inflammation seen in inflammatory bowel disease (IBD) predisposes to the development of colorectal adenocarcinoma. In contrast, colorectal neuroendocrine carcinomas (NECs) have rarely been reported in the setting of IBD, and no definitive relationship between these tumours and IBD has been established. Dysplasia from chronic inflammation leading to neuroendocrine cell differentiation may be responsible for NEC development, though this finding has not been seen consistently. We present a case of large-cell neuroendocrine carcinoma of the sigmoid colon in a 65-year-old woman with long-standing ulcerative colitis. Although she underwent regular endoscopic follow-ups and was receiving the tumour necrosis factor alpha inhibitor infliximab, her tumour was large and aggressive, with metastases to the liver discovered at time of diagnosis. This case highlights the aggressive nature and poor prognosis of NECs and stresses the need to identify patients at high risk of developing NECs and develop improved surveillance guidelines for detecting them.
- inflammatory bowel disease
- ulcerative colitis
- colon cancer
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Contributors PS contributed to the conception and design of the manuscript and the acquisition and interpretation of data. He also drafted the manuscript. DC contributed to the conception and design of the manuscript and revised the article critically for intellectually important content. He also provided final approval of the submitted manuscript. TG acquired the pathology slides and gross specimen pictures and labelled them. She also reviewed and revised the portions of the manuscript relating to pathological interpretation.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
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