As recently addressed in the WHO 2017 classification of pancreatic NEN (2) a morphologically still differentiated NET G3 subgroup with a Ki-67 in the lower proliferative range usually between 20 and 55% can be separated from the more aggressive and undifferentiated “classical” small or large cell NEC G3 which have a very poor prognosis. This evidence concerns the gene MKI67 and neuroendocrine carcinoma.