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A 50-year-old man was referred to our hospital for the further evaluation of a pancreatic mass. Contrast-enhanced computed abdominal tomography (CE-CT) showed a 35-mm solid mass in the pancreatic body with soft tissue around the tumor extending to the celiac plexus. Endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) for the pancreatic mass was performed (21-G needle, 3 passes) via the trans-gastric approach, confirming the diagnosis of adenocarcinoma. CE-CT indicated celiac plexus invasion , and chemotherapy was administered for 8 months, during which the tumor size was reduced. However, CE-CT showed soft tissue density (arrow) between the stomach and pancreatic tumor (T) (1). EUS also showed soft tissue (ar-row) from the stomach serosa (asterisk) to the pancreatic tumor (T) (2). Possible needle tract seeding was considered. We therefore planned distal pancreatectomy and partial stomach resection. The pathological findings of the resected specimen showed a pancreatic adenocarcinoma 25 mm in

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On the basis of a retrospective analysis of 124 patients, endoscopic therapy of WON by using LAMS is safe and effective. Creation of a large and sustained cystogastrostomy or cystoenterostomy tract is effective in the drainage and treatment of WON.

EUS-guided CPB was 51.46% effective in managing chronic abdominal pain in patients with chronic pancreatitis, but warrants improvement in patient selection and refinement of technique, whereas EUS-guided CPN was 72.54% effective in managing pain due to pancreatic cancer and is a reasonable option for patients with tolerance to narcotic analgesics.

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Endoscopic ultrasonography alone or with fine-needle aspiration biopsy adds useful diagnostic information in determining metastasis to posterior mediastinal or subcarinal lymph nodes in patients with non-small-cell lung-cancer. These procedures are especially helpful in the preoperative evaluation of patients with suspicious contralateral mediastinal or "bulky" subcarinal nodes.