“…This recommendation is based on the findings that NF-PanNENs of this size are not associated with increased mortality in MEN1 patients, many do not grow or show aggressive behavior, and these patients cannot be completely cured of PanNENs, because they all have small, microscopic NF-PanNEN tumors throughout the gland and only 0–12% ever become symptomatic [5, 11, 12, 45-47]. Only recently is this approach being increasingly used in patients with sporadic, asymptomatic NF-PanNENs [19-21, 23, 48]. This recommendation is not without controversy, with some authors advocating surgery for all PanNENs, whereas others support the conclusion that small, asymptomatic PanNENs are good candidates for surveillance [19-21, 49-52].…”