This seems to illustrate that when GCCs are discovered at an early stage with a low Ki67 index, they have an outcome similar to the classic appendiceal neuroendocrine tumors, while patients with high Ki67 index and disseminated disease at time of diagnosis have an outcome similar to gastrointestinal adenocarcinomas [12, 33]. Here, MKI67 is linked to neuroendocrine neoplasm.