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WHO Classification of Tumours
Mixed adenoneuroendocrine carcinoma
Region of the ampulla of Vater


Mixed adenoneuroendocrine carcinomas (MANEC) have a phenotype that is morphologically recognizable as both gland-forming epithelial and neuroendocrine, and are defined as carcinomas since both components are malignant and should be graded. A component of squamous cell carcinoma is rare. Arbitrarily, at least 30% of either component should be identified to qualify for this definition. The identification in adenocarcinoma of scattered neuroendocrine cells by immunohistochemistry does not qualify for this definition
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Bosman FT, Carneiro F, Hruban RH, Theise ND (Eds.)
WHO Classification of Tumours of the Digestive System.
4th Edition
International Agency for Research on Cancer: Lyon 2010


Commentary: Neuroendocrine tumours of the digestive system