Large-cell neuroendocrine carcinoma of the endometrium is an insufficiently researched aggressive tumor with a short survival regard­less of the treatment type. We present here the 38th consecutive case of literature reported cases of large cell neuroendocrine carcinoma of the endometrium (posi­tive for synaptophysin, CD56, chromogranin A, p53, and Vimentin) found in the myomatous uterus of a 76-year-old woman. We also describe in the study the morphological algorithm for differentiation of malignant blastomas with small (under 10 %) neuro-endocrinal component. Accumulated clinical and morphological evidence raises the question whether the large-cell and the small-cell neuroendocrine carcino­mas are just different variations according to their histology and topical occurrence (uterine body/cervix) or they are just independent forms with their respective clinical signs, morphology, treatment, and prognosis.