Introduction. Mixed adenocarcinoma-neuroendocrine cancer (MANEC) is a rare cancer that is characterized by aggressive course and poor prognosis. Aim. A case report and literature review. Description of the case. This article presents the case of a 63-year-old patient who was hospitalized due to the occurrence of neurological symptoms such as nausea, dizziness and headache as well as double vision and numbness of the hands. Suspected ischemic stroke, meningitis with bacterial etiology or brainstem pathology. Conclusion. MANEC composed of large neuroendocrine cells have better survival and clinical behavior than patients with small, intermediate or mixed large and intermediate cells.