Abstract
Rectal neuroendocrine tumors (NETs) are rare neoplasms that are usually asymptomatic and diagnosed incidentally. There are limited data on the presentation and management of high-grade poorly differentiated large friable rectal NETs. We report the first case of an 87-year-old male who presented with chronic diarrhea and subsequently had severe hematochezia complicated by hemorrhagic shock and cardiac arrest and was diagnosed with a 7-cm high-grade friable rectal NET. Our case sheds light on the need to consider NETs in cases of chronic diarrhea and on the importance of endoscopy-guided biopsy in the diagnosis and categorization, which can guide management.