Importantly, the authors were able to show an increased risk of relapse for DAXX/ATRX negative tumours also in the subgroup including 196 PanNET <2 cm.6 Indeed, despite their usual indolent behaviour, fewer than 15% of PanNETs ≤2 cm exhibit malignant features such as lymph node involvement, or recurrence after resection.1 Hence, management of PanNETs <2 cm represents a clinical dilaemma and markers able to predict tumour behaviour are needed. Here, ATRX is linked to neoplasm.