In contrast to sporadic PanNETs, ATRX and DAXX alterations were only seen in 6 % of PanNETs from MEN1 syndrome patients (but also as late event) and in 0 % of microadenomas suggesting a less important role for these alterations in MEN1 syndrome tumor progression [95]. This evidence concerns the gene ATRX and multiple endocrine neoplasia type 1.