How would you treat a mixed neuroendocrine/adenocarcinoma appendiceal tumor with metastasis to the liver?

I find it helpful to ask pathology to comment on the individual tumor components. If there is a substantial adenocarcinoma component in the tumor, I worry that platinum/etoposide may be inadequate as therapy. For a predominantly high-grade, poorly differentiated neuroendocrine carcinoma with a minor...

Thanks @Dr. First Last, I think that this is a great question. The first step is to confirm it is truly mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN). Given there is a lack of prospective data and the natural history/disease biology appears to be predominated with high grade NEC, I usuall...

I think the answer to this question is a bit more nuanced. In 2017, the WHO changed the term mixed adenoneuroendocrine carcinoma (MANEC) to mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN). These entities are defined by having at least 30% neuroendocrine and non-neuroendocrine components. Th...