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The choice of treatment is influenced by factors such as tumor stage, grade (proliferative activity), and the presence of hormone\u2010related syndromes. Endoscopic ultrasound (EUS) is becoming increasingly valuable for assessing pancreatic neuroendocrine neoplasms, offering detailed morphological, vascular, and functional information through techniques such as contrast enhancement and elastography. It also allows biopsies that are useful for both histopathological and molecular analyses. These tumors are highly heterogeneous, with treatment options ranging from observation to various medical therapies and surgery. Recent data suggest that small, non\u2010functioning PanNENs with low proliferation rates may be safely monitored, whereas more aggressive or functioning tumors typically require surgery. EUS\u2010guided ablation is a promising alternative for patients with functional pancreatic neuroendocrine neoplasms who are unsuitable for surgery, although randomized trials are needed. In non\u2010resectable pancreatic neuroendocrine neoplasms, treatment options include somatostatin analogs, targeted therapies (e.g., everolimus, sunitinib), chemotherapy, and radioligand therapy. This review discusses key factors in planning personalized treatment strategies for pancreatic neuroendocrine neoplasms.<\/jats:p>","DOI":"10.1002\/ueg2.12710","type":"journal-article","created":{"date-parts":[[2024,11,14]],"date-time":"2024-11-14T08:40:33Z","timestamp":1731573633000},"page":"34-43","source":"Crossref","is-referenced-by-count":13,"title":["Pancreatic Neuroendocrine Neoplasms: Classification and Novel Role of Endoscopic Ultrasound in Diagnosis and Treatment Personalization"],"prefix":"10.1002","volume":"13","author":[{"given":"Matteo","family":"Tacelli","sequence":"first","affiliation":[{"name":"Pancreato\u2010Biliary Endoscopy and Endosonography Division Pancreas Translational and Clinical Research Center IRCCS San Raffaele Scientific Institute  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Partelli","sequence":"additional","affiliation":[{"name":"Pancreatic Surgery Unit Pancreas Translational and Clinical Research 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