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Dear Enrique, I enclose the letter to reply the commenting letter of Modesto Varas. I thought appropiate to reply, in accordance with your proposal. It took me a bit to response because Modesto's letter is quite confusing, but I think positive to have letters on the Journal. If you consider opportune to comment on it, please don't hesitate to let me know. Thank you so much.

Neuroendocrine tumors of the pancreas: keys issues in dealing with heterogeneity