Given that the TP53 mutations were partially accompanied by other gene alterations, including ATRX, TSC2, TSC1, and PIK3CA, which have been previously reported in PanNETs [42], it can be inferred that these high-grade PanNENs also belong to the group designated as NEC-like G3NETs. This evidence concerns the gene PIK3CA and neuroendocrine carcinoma.