Extensive Neuroendocrine Adenocarcinoma in Ulcerative Colitis

A 42-year-old male with a known history of extensive ulcerative colitis [UC] and Leiden factor V mutation was admitted with abdominal pain and bloody diarrhoea of 4 days’ duration. He had uncontrolled, steroid-dependent UC since age 23. He was intolerant to thiopurines and had failed adalimumab. Four months earlier, he was hospitalised with deep venous and renal vein thrombosis. On examination, the patient looked unwell and emaciated and presented diffuse abdominal tenderness. Blood tests revealed severe …