Unusual Extra-intestinal Manifestations of Crohn Disease Complicated by Incidentally Diagnosed Pancreatic Neuroendocrine Tumor

Abstract

Crohn disease is associated with nonnecrotizing epithelioid granulomas, which rarely involve extra-intestinal solid organs. Management of moderate-to-severe Crohn disease, especially with extra-intestinal manifestations, relies on biologic therapies and small molecules which suppress the immune system and potentially increase cancer risk. We present the diagnosis and management of a rare case of Crohn disease with nonnecrotizing epithelioid granulomas in the sacral spine, pancreas, and peripancreatic soft tissue, complicated by an incidentally diagnosed pancreatic neuroendocrine tumor.