How would you approach the treatment of metastatic colon cancer with pathologic features indeterminate between adenocarcinoma and small cell carcinoma?

Mixed adenoneuroendocrine carcinomas of the colon (MANEC) can be collision tumors, composite tumors, or in this case, amphicrine tumors whose cells contain morphologic features of both. If the neuroendocrine component was grade 3, I would treat it as small cell carcinoma with etoposide/platinum.

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