Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare and aggressive lung cancer with limited therapeutic options and poorly defined metabolic features. To establish a comprehensive molecular overview, we generated the first metabolomics and lipidomics atlas of LCNEC using paired tumor and adjacent non-tumor lung tissues from 34 patients. Untargeted multiplatform liquid chromatography-mass spectrometry profiled 1052 metabolites, revealing extensive remodeling of amino acid, nucleotide, and lipid metabolism. Tumor tissues showed pronounced accumulation of both D- and L-2-hydroxyglutaric acid, indicating altered
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