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Krystallenia I Alexandraki Department of Surgery, Medical School, National and Kapodistrian University of Athens, Athens, Greece

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Gregory A Kaltsas Department of Propaedeutic Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

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Simona Grozinsky-Glasberg Department of Endocrinology and Metabolism, Neuroendocrine Tumor Unit, ENETS Center of Excellence, Hadassah Medical Organization and Faculty of Medicine, the Hebrew University, Jerusalem, Israel

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. Age (yrs)/sex a Previous treatments b Extra symptomatic therapy postPASI Grade (Ki67, %) Pasireotide therapy Disease free (m postPASI) Baratelli et al. (2014) 60, Male High-dose OCT LAR (20/m → 30/m → 60/m, BEVA + metronomic

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Wenzel M Hackeng Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands

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Lodewijk A A Brosens Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands

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Koen M A Dreijerink Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
Department of Endocrinology, Amsterdam University Medical Centers, VU University Medical Center, Amsterdam, The Netherlands

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referred to as ‘giant insulinomas’, of which 50% have distant metastases at presentation ( Ueda et al. 2016 ). In contrast to non-functioning PanNETs, tumor grade based on mitosis count per high power field or Ki-67 staining index is not univocally

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Emanuel Christ Division of Endocrinology, Diabetology and Metabolism and Center of Endocrine Tumors, University Hospital of Basel, Basel, Switzerland

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Donato Iacovazzo Centre for Endocrinology, William Harvey Research Institute, Barts and London School of Medicine, Queen Mary University of London, London, United Kingdom

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Márta Korbonits Centre for Endocrinology, William Harvey Research Institute, Barts and London School of Medicine, Queen Mary University of London, London, United Kingdom

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Aurel Perren Institute of Pathology, University of Bern, Bern, Switzerland

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invasive procedures, whereas, in particular, the calcium stimulation test requires the selective cannulation of the different feeding arteries of the pancreas and the hepatic vein ( Wiesli et al. 2004 a ). Although both tests have a high sensitivity and

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Alaa Sada Department of Surgery, Division of Endocrinology, Division of Gastroenterology and Hepatology, Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA

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Travis J McKenzie Department of Surgery, Division of Endocrinology, Division of Gastroenterology and Hepatology, Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA

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Adrian Vella Department of Surgery, Division of Endocrinology, Division of Gastroenterology and Hepatology, Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA

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Michael J Levy Department of Surgery, Division of Endocrinology, Division of Gastroenterology and Hepatology, Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA

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Thorvardur R Halfdanarson Department of Surgery, Division of Endocrinology, Division of Gastroenterology and Hepatology, Division of Medical Oncology, Mayo Clinic, Rochester, Minnesota, USA

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–3 mm from the main pancreatic and/or bile duct ( Howe et al. 2020 ). Although enucleation is associated with a high rate of pancreatic fistula, the rate of significant morbidity or mortality after enucleation is lower than segmental pancreatic

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