Publication Name	World Journal of Clinical Cases
Manuscript ID	123303
DOI	10.12998/wjcc.123303
Country	China

Category	Oncology
Manuscript Type	Case Report
Article Title	Large cell neuroendocrine carcinoma of the distal common bile duct: A case report and review of literature
Manuscript Source	Unsolicited Manuscript
All Author List	Bo-Qian Zheng, Ze-Pu Wang, Rui-Zeng Feng, Ze-Cun Zheng, Hong-Jie Wang, Hao Wang and Hong-Fang Tuo
Funding Agency and Grant Number
Corresponding Author	Hong-Fang Tuo, Associate Professor, Second Department of Hepatobiliary and Pancreatic Surgery, Hebei Provincial People's Hospital, No.348 Heping West Road, Xinhua District, Shijiazhuang City, Hebei Province, P.R. China, Shijiazhuang 050051, Hebei Province, China. tuohongfang2023@163.com
Key Words	Neuroendocrine carcinoma; Common bile duct; Pancreaticoduodenectomy; Multidisciplinary team; Case report
Core Tip	This case reports describe a distal common bile duct large cell neuroendocrine carcinoma (LCNEC) with a positive bile duct margin (R1 resection). Comprehensive immunohistochemistry revealed a proficient mismatch repair (MMR)/microsatellite stable phenotype, providing a molecular basis for excluding postoperative adjuvant immunotherapy. It is the first report of MMR testing directly guiding treatment decisions in biliary LCNEC, and clinicians are advised to incorporate MMR testing as a routine examination for biliary neuroendocrine carcinoma to inform immunotherapy decisions. With effective systemic therapy, positive margin (R1) resection does not preclude the possibility of favorable short-term outcomes. Multidisciplinary management that integrates molecular pathology is key to individualized treatment of rare tumors.
Citation	Zheng BQ, Wang ZP, Feng RZ, Zheng ZC, Wang HJ, Wang H, Tuo HF. Large cell neuroendocrine carcinoma of the distal common bile duct: A case report and review of literature. World J Clin Cases 2026; In press DOI: https://doi.org/10.12998/wjcc.123303
PDF	123303-in-press.pdf

Received	2026-05-18 08:10
Peer-Review Started	2026-05-18 08:10
First Decision by Editorial Office Director	2026-05-26 09:49
Return for Revision	2026-05-26 10:40
Revised	2026-06-18 21:12
Publication Fee Transferred	2026-07-16 03:27
Second Decision by Editor	2026-08-05 03:18
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-08-05 10:46
Articles in Press	2026-08-05 10:46
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2307-8960 (online)
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