Advances in the diagnosis and treatment of early‑onset pancreatic neuroendocrine neoplasms

With advances in imaging and the widespread use of routine health examina-tions, the incidence and detection of pancreatic neuroendocrine neoplasms have increased. Compared with the overall patient population, early‑onset pancreatic neuroendocrine neoplasms (EO‑pNENs) show distinct features in epidemiology, genetic background, molecular characteristics, and clinical presentation, which are also more frequently associated with hereditary syndromes, particularly multiple endocrine neoplasia type 1. Despite the growing number of studies, current evidence remains largely focused on clinicopathological characteristics and prognosis of EO‑pNENs, whereas systematic investigations into their biological nature, risk stratification, and individualized manage-ment are still limited. The authors summarize the current evidence on EO‑pNENs, including epide-miology, genetic background, clinical features, diagnostic evaluation, and treatment strategies, and further integrate molecular and genetic evidence to explore their potential biological mechanisms. This article aims to provide insights into early identification, risk assessment, and individualized treatment.