{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T20:00:57Z","timestamp":1785268857465,"version":"3.55.0"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>A pancreatic combined Grade 1 neuroendocrine tumour (NET) and ductal adenocarcinoma (PDAC) \u2014 meeting morphological criteria for both mixed neuroendocrine\u2013non-neuroendocrine neoplasm (MiNEN) and collision tumour \u2014 is exceptionally rare. We report a 68-year-old female with multifocal pancreatic cystic lesions, main pancreatic duct dilatation, and elevated CA 19\u20139, with imaging features consistent with intraductal papillary mucinous neoplasm. Following multidisciplinary review, total pancreatectomy with duodenectomy and Roux-en-Y reconstruction was performed. Histopathology revealed PDAC (65%) and a well-differentiated Grade 1 PanNET (35%), with the latter confirmed by diffuse positivity for Synaptophysin and Chromogranin A and Ki-67\u2009&amp;lt;\u20091%. A co-existing simple mucinous cyst with high-grade dysplasia was also identified. Adjuvant XELOX chemotherapy was administered after the patient declined infusional FOLFOX. This case highlights the diagnostic challenge of distinguishing MiNEN from collision tumour in the absence of molecular clonality data, and adds to the sparse literature on combined pancreatic NET\u2013PDAC neoplasms.<\/jats:p>","DOI":"10.1093\/jscr\/rjag641","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T11:51:49Z","timestamp":1783597909000},"source":"Crossref","is-referenced-by-count":0,"title":["Combined pancreatic grade 1 neuroendocrine tumour and ductal adenocarcinoma \u2014 MiNEN versus collision tumour: a rare surgical case report and diagnostic challenge"],"prefix":"10.1093","volume":"2026","author":[{"given":"Noufel","family":"Alshadood","sequence":"first","affiliation":[{"name":"Surgical Department, Warith International Cancer Institute , Karbala ,","place":["Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suha Hazem","family":"Yasir","sequence":"additional","affiliation":[{"name":"Oncology Department, Warith International Cancer Institute , Karbala ,","place":["Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4082-4838","authenticated-orcid":false,"given":"Ali Naser","family":"Aldarawsha","sequence":"additional","affiliation":[{"name":"Oncology Department, Warith International Cancer Institute , Karbala ,","place":["Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flayyih Hasan","family":"Yousif","sequence":"additional","affiliation":[{"name":"Oncology Department, Warith International Cancer Institute , Karbala ,","place":["Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Samy","family":"Elazab","sequence":"additional","affiliation":[{"name":"Radiology Department, Warith International Cancer Institute , Karbala ,","place":["Iraq"]},{"name":"Radiology Department, National Cancer Institute, Cairo University , Cairo ,","place":["Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sora Ali","family":"Hasan","sequence":"additional","affiliation":[{"name":"Histopathology Department, Warith International Cancer Institute , Karbala ,","place":["Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasan","family":"Ammash","sequence":"additional","affiliation":[{"name":"Surgical Department, Warith International Cancer Institute , Karbala ,","place":["Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa Nabeel","family":"Mahmood","sequence":"additional","affiliation":[{"name":"Surgical Department, Warith International Cancer Institute , Karbala ,","place":["Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"2026072815135632800_ref1","volume-title":"Digestive System Tumours","author":"WHO Classification of Tumours Editorial 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report","volume":"2024","author":"Ba\u00eda","year":"2024","journal-title":"J Surg Case Rep"},{"key":"2026072815135632800_ref5","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1186\/s13000-021-01165-5","article-title":"Case report: composite pancreatic intraductal papillary mucinous neoplasm and neuroendocrine tumor: a new mixed neuroendocrine-non-neuroendocrine neoplasm?","volume":"16","author":"Chen","year":"2021","journal-title":"Diagn Pathol"},{"key":"2026072815135632800_ref12","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011044.pub3","article-title":"Chemotherapy and radiotherapy for advanced pancreatic cancer","author":"Haggstrom","journal-title":"Cochrane Database Syst Rev"},{"key":"2026072815135632800_ref13","first-page":"3240569","article-title":"A rare case of mixed neuroendocrine tumor and adenocarcinoma of the pancreas","volume":"2016","author":"Chrysos","year":"2016","journal-title":"Case Rep Surg"},{"key":"2026072815135632800_ref6","first-page":"111320","article-title":"Concurrent pancreatic ductal adenocarcinoma and poorly differentiated neuroendocrine carcinoma: a case report and review of the literature","volume":"121","author":"Negahi","year":"2025","journal-title":"Int J Surg Case Rep"},{"key":"2026072815135632800_ref10","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1016\/j.pan.2017.07.007","article-title":"Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas","volume":"17","author":"Tanaka","year":"2017","journal-title":"Pancreatology"},{"key":"2026072815135632800_ref11","first-page":"5021","article-title":"Intraductal papillary mucinous neoplasm of the pancreas: current management and surgical decision-making strategies","volume":"11","author":"Scholten","year":"2022","journal-title":"J Clin 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