Small-cell neuroendocrine colon carcinoma is a rare entity with a usually poor prognosis. An 80- year-old female had colon cancer surgery due to synchronous tumour of the rectum and caecum. Pathohystological analysis of the caecal tumour showed trabecular and solid clusters, relatively uniformed small to middle sized epithelial cells, deficient cytoplasm and there were a great number of mitosis with larger areas of necrosis in the connective tissue. The immunohistochemistry was positive for chromogranin A. The caecal tumour was diagnosed as a small-cell neuroendocrine carcinoma. In addition, the rectal tumour showed microscopic findings consistent with stage IIA adenocarcinoma. The immunohistochemical panel showed that the tumour was negative for neuroendocrine markers. There were no clinical findings suggestive of hormone hypersecretion. Cancer métastasés were not found. Postoperative chemotherapy was applied. The patient is still alive, in good general condition and with no signs of tumour progression.