Amphicrine carcinomas of the pancreas (AmpCA) are exceedingly rare (<0.1%) and are characterized by monomorphic tumor cells showing bidirectional (i.e. exocrine and endocrine) differentiation. Tumor cells showed electron-dense granules in two size ranges <200 and >500 nm (f, ×20000) gl Follow-up: At the time of this publication, patient 1 had developed metastatic AmpCA in the liver 31 months post-surgery. It is crucial to note that in current MAcNEC, dual staining for acinar and endocrine markers reveals a single line of differentiation in most tumor cells.3 In contrast, most tumor cells show bidirectional differentiation in AmpCA.1,2 Similarly, AmpCA can potentially be classified as MAcNEC with Amphicrine features. [Extracted from the article]