A Rare Connection: Case Report of Neuroendocrine Tumors Misdiagnosed as Hemorrhoids

Background: Hemorrhoids are a prevalent condition affecting the anal and rectal area, often resulting in symptoms such as bleeding, pain, and prolapse. While typically benign, they can coexist with other anorectal issues, including anal fissures and polyps. Rarely, neuroendocrine tumors may be discovered in patients with hemorrhoids, underscoring the necessity for thorough evaluation and histopathological examination to identify and address any significant underlying conditions. Case Presentation: This case describes a 39-year-old male presenting to the clinic on August 13, 2024. He reported a one-year history of rectal bleeding, pain, burning, and prolapse during defecation, along with occasional constipation. Physical examination revealed third-degree hemorrhoids, a chronic anal fissure, and an anal polyp. The primary diagnosis was third-degree hemorrhoids, with secondary diagnoses of chronic anal fissure, anal polyp, and constipation. The patient underwent elective surgical interventions, including stapler hemorrhoidopexy, fissurectomy, sphincterotomy, and excision of the anal polyp, all performed under general anesthesia without complications. Histopathological analysis of the excised hemorrhoidal tissue revealed a Grade 1 neuroendocrine tumor measuring 3 mm, with no evidence of malignancy elsewhere. Postoperative recovery was stable, with the patient reporting no significant complications during follow-up. Conclusion: This case illustrates the complexity of managing hemorrhoidal disease and its potential associations with other anorectal conditions, such as anal fissures and polyps. The identification of Grade 1 neuroendocrine tumors emphasizes the importance of thorough evaluation in patients presenting with rectal symptoms, even when benign conditions are suspected.