{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T23:28:30Z","timestamp":1773530910945,"version":"3.50.1"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T00:00:00Z","timestamp":1726099200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T00:00:00Z","timestamp":1726099200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Diagn Pathol"],"DOI":"10.1186\/s13000-024-01546-6","type":"journal-article","created":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T10:04:17Z","timestamp":1726135457000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Navigating the diagnostic gray zone: a challenging case of pancreatic high-grade neuroendocrine neoplasm"],"prefix":"10.1186","volume":"19","author":[{"given":"Brooke","family":"Mullen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert L.","family":"Sy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priscila","family":"Dias Goncalves","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Lisa","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,9,12]]},"reference":[{"key":"1546_CR1","unstructured":"Who Classification of Tumours Editorial Board. Digestive System Tumours. International Agency for Research on Cancer; 2019."},{"issue":"4","key":"1546_CR2","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1056\/NEJMcpc2115858","volume":"387","author":"AW Baughman","year":"2022","unstructured":"Baughman AW, Wei NJ, Hahn PF, Casey BW, Zhang ML. Case 23-2022: a 49-Year-old man with hypoglycemia. N Engl J Med. 2022;387(4):356\u201365.","journal-title":"N Engl J Med"},{"key":"1546_CR3","doi-asserted-by":"publisher","unstructured":"Ursprung S, Zhang ML, Asmundo L, Hesami M, Najmi Z, Ca\u00f1amaque LG et al. An Illustrated Review of the Recent 2019 World Health Organization Classification of Neuroendocrine Neoplasms: A Radiologic and Pathologic Correlation. J Comput Assist Tomogr [Internet]. 2024; https:\/\/doi.org\/10.1097\/RCT.0000000000001593","DOI":"10.1097\/RCT.0000000000001593"},{"key":"1546_CR4","doi-asserted-by":"publisher","unstructured":"Tang LH. Pancreatic Neuroendocrine Neoplasms: Landscape and Horizon. Arch Pathol Lab Med [Internet]. 2020; https:\/\/doi.org\/10.5858\/arpa.2019-0654-RA","DOI":"10.5858\/arpa.2019-0654-RA"},{"issue":"3","key":"1546_CR5","doi-asserted-by":"publisher","first-page":"100065","DOI":"10.1016\/j.modpat.2022.100065","volume":"36","author":"SE Umetsu","year":"2023","unstructured":"Umetsu SE, Kakar S, Basturk O, Kim GE, Chatterjee D, Wen KW, et al. Integrated genomic and clinicopathologic Approach distinguishes pancreatic Grade 3 neuroendocrine Tumor from Neuroendocrine Carcinoma and identifies a Subset with Molecular Overlap. Mod Pathol. 2023;36(3):100065.","journal-title":"Mod Pathol"},{"issue":"4","key":"1546_CR6","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1158\/1078-0432.CCR-15-0548","volume":"22","author":"LH Tang","year":"2016","unstructured":"Tang LH, Untch BR, Reidy DL, O\u2019Reilly E, Dhall D, Jih L, et al. Well-differentiated neuroendocrine tumors with a morphologically apparent high-Grade Component: a pathway distinct from poorly differentiated neuroendocrine carcinomas. Clin Cancer Res. 2016;22(4):1011\u20137.","journal-title":"Clin Cancer Res"},{"issue":"5","key":"1546_CR7","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1097\/PAS.0000000000000408","volume":"39","author":"O Basturk","year":"2015","unstructured":"Basturk O, Yang Z, Tang LH, Hruban RH, Adsay NV, McCall CM, et al. The high grade (WHO G3) pancreatic neuroendocrine tumor category is morphologically and biologically heterogeneous and includes both well differentiated and poorly differentiated neoplasms. Am J Surg Pathol. 2015;39(5):683.","journal-title":"Am J Surg Pathol"},{"issue":"9","key":"1546_CR8","doi-asserted-by":"publisher","first-page":"1192","DOI":"10.1097\/PAS.0000000000000662","volume":"40","author":"LH Tang","year":"2016","unstructured":"Tang LH, Basturk O, Sue JJ, Klimstra DS. A practical Approach to the classification of WHO Grade 3 (G3) well-differentiated neuroendocrine tumor (WD-NET) and poorly differentiated neuroendocrine carcinoma (PD-NEC) of the pancreas. Am J Surg Pathol. 2016;40(9):1192\u2013202.","journal-title":"Am J Surg Pathol"},{"issue":"1","key":"1546_CR9","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1093\/annonc\/mds276","volume":"24","author":"H Sorbye","year":"2013","unstructured":"Sorbye H, Welin S, Langer SW, Vestermark LW, Holt N, Osterlund P, et al. Predictive and prognostic factors for treatment and survival in 305 patients with advanced gastrointestinal neuroendocrine carcinoma (WHO G3): the NORDIC NEC study. Ann Oncol. 2013;24(1):152\u201360.","journal-title":"Ann Oncol"},{"issue":"6","key":"1546_CR10","doi-asserted-by":"publisher","first-page":"2731","DOI":"10.1007\/s12325-022-02103-7","volume":"39","author":"D Smith","year":"2022","unstructured":"Smith D, Lepage C, Vicaut E, Dominguez S, Coriat R, Dubreuil O, et al. Observational study in a Real-World setting of targeted therapy in the systemic treatment of Progressive Unresectable or Metastatic Well-differentiated pancreatic neuroendocrine tumors (pNETs) in France: OPALINE Study. Adv Ther. 2022;39(6):2731\u201348.","journal-title":"Adv Ther"},{"key":"1546_CR11","doi-asserted-by":"publisher","unstructured":"Zhang HY, Cheng XB, Li Y, Jin LD, Yin HP. Effect of everolimus on the expression of Ki-67 and caspase-3 in patients with neuroendocrine tumors. Genet Mol Res [Internet]. 2017;16(1). https:\/\/doi.org\/10.4238\/gmr16019486","DOI":"10.4238\/gmr16019486"},{"key":"1546_CR12","doi-asserted-by":"publisher","first-page":"153341","DOI":"10.1016\/j.prp.2021.153341","volume":"219","author":"JS Gandhi","year":"2021","unstructured":"Gandhi JS, Alnoor F, Sadiq Q, Solares J, Gradowski JF. SMARCA4 (BRG1) and SMARCB1 (INI1) expression in TTF-1 negative neuroendocrine carcinomas including merkel cell carcinoma. Pathol Res Pract. 2021;219:153341.","journal-title":"Pathol Res Pract"},{"issue":"1","key":"1546_CR13","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.1038\/s41467-018-03099-x","volume":"9","author":"J George","year":"2018","unstructured":"George J, Walter V, Peifer M, Alexandrov LB, Seidel D, Leenders F, et al. Integrative genomic profiling of large-cell neuroendocrine carcinomas reveals distinct subtypes of high-grade neuroendocrine lung tumors. Nat Commun. 2018;9(1):1048.","journal-title":"Nat Commun"},{"issue":"3","key":"1546_CR14","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1016\/j.ygyno.2021.04.019","volume":"161","author":"X Pei","year":"2021","unstructured":"Pei X, Xiang L, Chen W, Jiang W, Yin L, Shen X, et al. The next generation sequencing of cancer-related genes in small cell neuroendocrine carcinoma of the cervix. Gynecol Oncol. 2021;161(3):779\u201386.","journal-title":"Gynecol Oncol"}],"container-title":["Diagnostic Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13000-024-01546-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13000-024-01546-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13000-024-01546-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T10:06:27Z","timestamp":1726135587000},"score":1,"resource":{"primary":{"URL":"https:\/\/diagnosticpathology.biomedcentral.com\/articles\/10.1186\/s13000-024-01546-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,12]]},"references-count":14,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["1546"],"URL":"https:\/\/doi.org\/10.1186\/s13000-024-01546-6","relation":{},"ISSN":["1746-1596"],"issn-type":[{"value":"1746-1596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,12]]},"assertion":[{"value":"8 July 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 September 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 September 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the Dana Farber Cancer Institute (DFCI) Institutional Review Board (Protocol 02-240). The patient provided written consent for the participating in research activities.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The patient provided written consent for the publication of this case report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"123"}}