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Ovarian cancer is the most lethal gynecological malignancy, with HGSCO being the most common (60\u201370%) and aggressive subtype, characterized by insidious symptoms and poor prognosis. Neuroendocrine carcinoma (NEC) is a poorly differentiated, high-grade tumor. Their coexistence challenges individualized therapy and confers a poor prognosis. In this case, both components were present in the ovaries, with lung NEC nodules detected 2 years later. Second-generation sequencing revealed shared TP53, PRDM1, and KIT mutations in all three tumors, indicating a common origin from a pluripotent cancer stem cell and suggesting lung NEC metastasized from the ovary. A SPEN mutation was unique to HGSCO, implying a role in HGSCO differentiation, while a PLCG2 mutation occurred only in metastatic lung NEC, indicating a potential key role in lung metastasis.<\/jats:p>","DOI":"10.1007\/s00795-025-00453-z","type":"journal-article","created":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T07:39:38Z","timestamp":1770449978000},"page":"106-112","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Genetic mutations in primary and metastatic tumors of a rare mixed neuroendocrine carcinoma and high-grade serous ovarian cancer"],"prefix":"10.1007","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2521-8652","authenticated-orcid":false,"given":"Qiqi","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fenghui","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoufeng","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fenglei","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yamei","family":"Dang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,7]]},"reference":[{"key":"453_CR1","doi-asserted-by":"publisher","first-page":"104044","DOI":"10.1016\/j.critrevonc.2023.104044","volume":"188","author":"L Cattaneo","year":"2023","unstructured":"Cattaneo L et al (2023) Digestive MiNENs: Could histological classification and molecular characterization drive clinical outcome and therapeutic approach? 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