Neuroendocrine Tumor of the Terminal Ileum Presenting as Refractory Crohn's Disease: A Diagnostic Challenge.

Neuroendocrine tumors (NETs) can mimic inflammatory bowel diseases like Crohn's, often delaying diagnosis. We report a case of a 56-year-old woman with abdominal pain, diarrhea, and weight loss initially treated as Crohn's disease. Despite immunomodulatory therapy, symptoms persisted. Imaging revealed ileal strictures and a suspicious mass. Surgical resection was performed, and histopathology confirmed a Grade 1 well-differentiated ileal NET (pT4 pN1) with lymphovascular and perineural invasion. The patient was referred for oncology follow-up. This case highlights the need to consider NETs in patients with gastrointestinal symptoms that mimic Crohn's disease but fail to respond to standard therapies.