Neuroendocrine tumors (NETs) are heterogeneous, widely distributed tumors arising from neuroendocrine cells. Gastrointestinal (GI)-NETs are the most common and NETs of the rectum represent 15, 2% of gastrointestinal malignancies. Poorly differentiated neuroendocrine carcinomas of the GI tract are uncommon. | Poorly differentiated neuroendocrine rectal carcinoma with uncommon immunehistochemical features and clinical presentation with a subcutaneous metastasis treated with first line intensive triplet chemotherapy plus bevacizumab FIrB FOx regimen An experience of multidisciplinary management in clinical practice