Large cell neuroendocrine carcinoma of the distal common bile duct: A case report and literature review

Table 1 Key contributions of the multidisciplinary team at major decision nodes

Treatment stage	Core contributions of MDT
Diagnosis	Department of Radiology and Ultrasound interpreted the “fast-in, fast-out” imaging features of the lesion, suggesting the possibility of a neuroendocrine tumor
Preoperative	Department of Interventional Radiology performed percutaneous transhepatic cholangiography and drainage to ensure surgical safety; the Department of Surgery formulated the surgical plan for laparoscopic pancreaticoduodenectomy
Pathology	Comprehensive immunohistochemical tests (including MMR protein testing) were performed, confirming proficient MMR and excluding indications for immunotherapy
Adjuvant therapy	Department of Medical Oncology formulated the EP regimen; the Department of Pathology reconfirmed no indications for immune checkpoint inhibitor therapy
Follow-up	Multidisciplinary coordination completed imaging reexamination and clinical efficacy evaluation

MMR: Mismatch repair; MDT: Multidisciplinary team; EP: Etoposide plus.