Mixed adenoneuroendocrine carcinoma: A report of four cases from South India

Abstract

Neuroendocrine tumors (NET) are rare. Common sites of NETs are the gastrointestinal tract and pancreas. In 2010, the World Health Organization classified NETs into mixed adenoneuroendocrine carcinoma, neuroendocrine carcinoma and mixed adenoneuroendocrine carcinoma (MANEC), tumors that have both exocrine and endocrine components of at least 30% each. Since it is relatively a new entity, only case reports and case series are available. In the past 7 years, there were only eight reports from India. We report a further four cases of this nascent disorder from a single institution, obtained retrospectively. The first includes an elderly man with upper gastrointestinal symptoms and underwent subtotal gastrectomy for antropyloric growth, which was a low-grade MANEC. The second was a female patient with chronic pancreatitis and presented with obstructive jaundice due to an ampullary growth. Whipple's specimen showed an intermediate-grade MANEC. The third case was a 40-year-old female with caecal growth and ovarian mass and was found to have a low-grade MANEC. The fourth, also in a female, was a case of abdominal wall abscess with an intraabdominal connection to the intestine and she had omental deposits and high-grade MANEC. The pathological findings are discussed and compared other reports from the country.