A First Report of Tumor Seeding by EUS-FNA

Paquin, Sarto C.; Chua, Tju Siang; Tessier, G.; Gariépy, Gilles; Raymond, Ginette; Bourdages, Raymond; Sahai, Anand V.

doi:10.1016/s0016-5107(04)01058-2

Cited by 5 publications

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“…There is one report of the seeding of cancer cells into the gastric wall after EUS-guided FNA in a patient with pancreatic tail adenocarcinoma. 12 In that case, EUS-guided FNA was performed through the gastric wall, and the surgical procedure did not include resection of the biopsy tract. The author of that report warns that EUS-guided FNA should be avoided or the number of passes should be kept to a minimum if EUS-guided FNA results are unlikely to prevent surgery (e.g., very high pretest likelihood of operable cancer) and the surgical procedure will not include resection of the intestinal biopsy tract (e.g., distal pancreatectomy).…”

Section: Discussionmentioning

confidence: 99%

Utility of pancreatic duct brushing for diagnosis of pancreatic carcinoma

et al. 2007

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Section: Discussionmentioning

confidence: 99%

Utility of pancreatic duct brushing for diagnosis of pancreatic carcinoma

et al. 2007

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“…[36,37] This may pose a potential problem if the needle tract is not resected with the primary lesion, as in a distal pancreatic tumor. However, further review of this issue is warranted before we can conclude that EUS-FNA should not be performed in potentially resectable pancreatic tumors.…”

Section: Controversies In Eus-fna Of Pancreatic Lesionmentioning

confidence: 99%

Endoscopic ultrasonography in the diagnosis and management of cancer

Pungpapong¹,

Noh²,

Wallace³

2005

Expert Review of Molecular Diagnostics

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Since its development and introduction to clinical practice, endoscopic ultrasonography (EUS) has progressed rapidly from being a purely imaging modality with limited use in the detection of small pancreatic cancers to one that can provide a tissue diagnosis by fine-needle aspiration (FNA) and deliver therapy. EUS has now firmly established a place as the investigation of choice in the diagnosis, locoregional staging and management of a wide range of gastrointestinal cancers. With the increasing use of FNA, the accuracy of EUS has substantially improved and may become a stand-alone investigation in some situations. However, it is recommended that a combination of information obtained from other imaging modalities and EUS is needed to maximize the accuracy, in particular to complete staging beyond locoregional stage. In addition to well-established indications, newer applications of EUS are emerging and are no longer limited to the gastrointestinal system. In lung cancer, EUS combined with endobronchial ultrasonography is emerging as an accurate, minimally invasive, nonsurgical alternative to staging of the mediastinum. Furthermore, the ability of EUS to acquire tissue safely and conveniently results in a potential role of the molecular diagnostics to enhance the performance of EUS-guided FNA. Besides a diagnostic role of EUS, there continues to be technological advances in the field of interventional EUS, with many potential applications under investigation. This review focuses on the current and future roles of EUS in the diagnosis and management of cancers.

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“…This is especially true when there is concurrent acute or chronic pancreatititis that may mimic a focal pancreatic cancer. Although the risk of FNA is low, a recent preliminary report of tumor seeding by EUS‐FNA should raise caution when considering FNA of resectable tumors, 22 especially those in the body or tail of the pancreas where the needle track is not resected in the subsequent surgery.…”

Section: Pancreatic Adenocarcinomamentioning

confidence: 99%

Endoscopic Ultrasound and Fine‐needle Aspiration for Pancreatic Cancer

Wallace

Woodward

Raimondo

2004

Digestive Endoscopy

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Background : Accurate staging of pancreatic cancer is essential for surgical planning, and identification of locally advanced and metastatic disease that is incurable by surgery. Advances in EUS, CT, and PET have improved the accuracy of staging and reduced the number of incomplete surgical resections. Tissue acquisition is necessary in non-surgical cases when chemoradiotherapy is considered. The complex regional anatomy of the pancreas makes cytologic diagnosis of malignancy at this region difficult without exploratory surgery. Although CT-guided fine-needle aspiration (FNA) is used for this purpose, reports of an increased risk of peritoneal dissemination of cancer cells and a false negative rate of nearly 20% makes this a less than ideal choice. The ability to position the EUS-transducer in direct proximity to the pancreas by means of stomach and the duodenum, combined with the use of FNA, increases the specificity of EUS in detecting pancreatic malignancies. Methods : The current literature regarding the accuracy of EUS with FNA in the evaluation of pancreatic cancer is reviewed. Results : EUS accuracy for tumor (T) staging ranges from approximately 78-94% and nodal (N) stage accuracy between 64 and 82%. EUS also enables FNA of lesions that are too small to be identified by CT or MRI, or too close to vascular structures to safely allow percutaneous biopsy. The accuracy for detecting invasion into the superior mesenteric artery and vein is lower than that for detecting portal or splenic vein invasion, especially for large tumors. EUS permits delivery of localized therapy such as celiac plexus neurolysis for pain control and direct intralesional injection of antitumor therapy. Conclusions : EUS in combination with FNA is a highly accurate method of preoperative staging of pancreatic cancer especially those too small to characterize by CT or MRI, and has the ability to obtain cytological confirmation.

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A First Report of Tumor Seeding by EUS-FNA

Cited by 5 publications

References 0 publications

Utility of pancreatic duct brushing for diagnosis of pancreatic carcinoma

Utility of pancreatic duct brushing for diagnosis of pancreatic carcinoma

Endoscopic ultrasonography in the diagnosis and management of cancer

Endoscopic Ultrasound and Fine‐needle Aspiration for Pancreatic Cancer

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