ArticleInternational journal of surgery case reports2026
Mixed adenoneuroendocrine carcinoma (MANEC) of the ampulla of Vater with sarcomatosis: a case report.
Article in International journal of surgery case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Biliary mixed neuroendocrine-non-neuroendocrine neoplasms (MiNENs) are rare, accounting for only 4-24% of all intestinal MiNENs. Diagnosing them preoperatively remains challenging due to the limitations of biopsy and imaging. As a result, the optimal treatment strategy, particularly for postoperative management, is still poorly defined. Case presentation: A 61-year-old woman presented to the Surgical Department of Sfax General Hospital on 23 December 2021, with a 1-month history of jaundice, yellow discoloration of the eyes and urine, and clay-colored stools. Contrast-enhanced CT revealed dilated intra- and extrahepatic biliary ducts without evidence of stones or masses in the common bile duct. A positron emission tomography scan confirmed peritoneal and thoracic adenomegaly. Intervention: The patient underwent a cephalic pancreatoduodenectomy (Whipple procedure). Outcomes histopathology: Histopathological examination of the surgical specimen confirmed a MiNEN. This case is particularly noteworthy for its rare association of a biliary MiNEN with a sarcomatoid component. Conclusion: This case highlights the diagnostic and therapeutic complexities of biliary MiNENs. Given their rarity, sharing evidence-based clinical experiences is vital to standardize practices and improve patient outcomes. This report emphasizes the need for a multidisciplinary approach and thorough histopathological analysis to ensure accurate diagnosis and tailored management.
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