Colorectal neuroendocrine tumours are rare A 78 year old man with a history of hypertension, heart disease, pacemakers, prostate adenocarcinoma.On examination for rectal bleeding, a colonoscopy was performed and at 5 cm of the anal margin a 28 mm ulcerated neoformation was found.An echo-endoscopy revealed infiltration of the muscular layer with an area of loss in the cleavage plane loss and fraying of the perirectal fat infiltration suggestive of infiltration (T3). They no lymph nodes or metastasis were identified by CAT. Radiotherapy treatment is ruled out due to having had it previously on the prostate and a proctectomy was opted for with mesorectal resection and Hartmann intervention. The pathology report revealed a large cell neuroendocrine carcinoma with numerous implants in perirectal adipose tissue and lymph metastasis in 2 lymph nodes (pT4aN1b), positive for synaptophysin, chromogranin and CD 56 with proliferation index Ki-67 50%.