A Case of Mixed Neuroendocrine-non-neuroendocrine Neoplasm of the Bile Duct with Spinal Paralysis due to Thoracic Vertebra Metastasis of the Neuroendocrine Carcinoma Components

Key Points

• To present a rare case of a mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) of the bile duct with spinal involvement.
• Case report of a 65-year-old male with distal bile duct cancer.
• Surgical intervention included pancreatoduodenectomy with preservation of the stomach.
• Immunohistochemical analysis confirmed neuroendocrine tumor markers in tumor samples.
• Postoperative chemotherapy with S-1 therapy was administered.
• Patient experienced sudden lower limb paralysis 9 months post-surgery.
• Diagnosis of spinal cord compression due to thoracic vertebral metastasis was made.
• Improvement of paralysis symptoms was achieved following surgical intervention for decompression.
• Patient later exhibited multiple liver metastases and died approximately 11 months after initial surgery.