MKI67 and neoplasm: Alternatively, diagnosis is made retrospectively following an appendectomy or liver biopsy.3 These neoplasms most frequently originate in the digestive system and, to a lesser extent, in the lungs.4 NENs are frequently detected in the metastatic stage, and their clinical behavior and prognosis vary greatly according to the primary tumor location, tumor morphology, grade, and Ki-67 level.5 For patients with metastatic or relapsed disease, a multidisciplinary approach is essential.