A case of malignant carcinoid tumor (neuroendocrine carcinoma) of the cecum is described. The neoplasm arose in a patient who had chronic ulcerative colitis for 16 years. There is no previous documentation of this combination, which is surprising, in view of the known association of colonic adenocarcinomas and lymphomas with ulcerative colitis. The reasons for this discrepancy are discussed and it is postulated that ultrastructural examination of poorly differentiated colonic neoplasms may result in a more frequent identification of this association.