Aneesh PSR, Vaithiyam V. Challenges in evaluating high-grade pancreato-hepato-biliary neuroendocrine tumors. World J Gastrointest Endosc 2025; 17(10): 111259 [DOI: 10.4253/wjge.v17.i10.111259]
Corresponding Author of This Article
Venkatesh Vaithiyam, Assistant Professor, Department of Gastroenterology, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, 1, Jawaharlal Nehru Marg, 64 Khamba, Raj Ghat, Central Delhi, New Delhi 110002, India. venkateshvaithiyam172@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Oct 16, 2025; 17(10): 111259 Published online Oct 16, 2025. doi: 10.4253/wjge.v17.i10.111259
Challenges in evaluating high-grade pancreato-hepato-biliary neuroendocrine tumors
Payila Satya Raghava Aneesh, Venkatesh Vaithiyam
Payila Satya Raghava Aneesh, Venkatesh Vaithiyam, Department of Gastroenterology, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi 110002, India
Author contributions: Aneesh PSR wrote the original draft; Vaithiyam V contributed to conceptualization, writing, reviewing, and editing; Aneesh PSR and Vaithiyam V participated in the manuscript drafting. All authors have read and approved the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Venkatesh Vaithiyam, Assistant Professor, Department of Gastroenterology, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, 1, Jawaharlal Nehru Marg, 64 Khamba, Raj Ghat, Central Delhi, New Delhi 110002, India. venkateshvaithiyam172@gmail.com
Received: June 26, 2025 Revised: July 17, 2025 Accepted: September 11, 2025 Published online: October 16, 2025 Processing time: 111 Days and 20.4 Hours
Abstract
We read with great interest and commend Tasneem et al for their valuable study on pancreato-hepatobiliary neuroendocrine tumors diagnosed via endoscopic ultrasound-guided biopsy. While the study offers important insights, we raise concerns regarding lesion classification, the lack of correlation between tumor size and aggressiveness, and the limited predictive value of individual clinical factors. Notably, many extra-pancreatic lesions may represent metastases rather than primary tumors. We advocate for a more comprehensive risk stratification approach and suggest incorporating novel molecular markers and analysis of the tumor microenvironment. Larger prospective studies are essential to enhance understanding and management of these rare and heterogeneous neoplasms.
Core Tip: The pancreato-hepatobiliary neuroendocrine tumors are rare, heterogeneous neoplasms. Therefore, individual tumor prognosis prediction is essential. Although various clinicopathological factors influence the aggressiveness of tumors, no single factor can accurately predict prognosis. Hence, efforts towards the development of novel markers, such as identifying gene mutations and the tumor microenvironment in biopsy specimens, would have brought new research insights.
