EUS-guided FNA in the diagnosis of pancreatic neuroendocrine tumors before surgery

Ardengh, José Celso; Paulo, Gustavo Andrade de; Ferrari, Ângelo Paulo

doi:10.1016/s0016-5107(04)01807-3

Cited by 109 publications

(87 citation statements)

References 23 publications

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“…In 2 patients, pancreatic metastases were diagnosed by EUS-FNA, a modality that has been reported to be useful for diagnosing pancreatic masses, including NETs [16]. The accuracy of EUS-FNA has been reported to be 80% for diagnosing pNETs [17,18]. The concordance rate for grading pNETs between specimens obtained by EUS-FNA and surgery has been reported to be 87.5% [19].…”

Section: Discussionmentioning

confidence: 99%

A Case of Distal Pancreatectomy for Pancreatic Metastasis of Thymic Atypical Carcinoid

Inoue¹,

Tanemura²,

Irei³

et al. 2017

AJMCR

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Background: Thymic atypical carcinoid(AC) tends to have a more aggressive clinical course than typical carcinoid(TC). About 20%-30% of patients with thymic AC experience local recurrence or distant metastasis. Pancreatic metastasis of thymic AC is extremely infrequent. We experienced a case of pancreatic metastasis of thymic atypical carcinoid, in which a distal pancreatectomy was performed. Case presentation: A 50-year-old man underwent thoracoscopic resection of a mediastinal tumor in June 2009. The diagnosis was thymic AC. He also underwent an extended thymectomy in October 2011, thoracoscopic resection in October 2012, and tumor resection of the chest wall in March 2013 for recurrences. During follow up in April 2014, computed tomography (CT) revealed lymph node swelling on the ventral side of the brachiocephalic vein, around the left gastric vein, and on the left side of the celiac artery. Dynamic CT revealed a pancreatic tumor 10 mm in diameter with low enhancement. EUS-guided fine-needle aspiration (EUS-FNA) biopsy revealed the pancreatic tumor was compatible with metastasis of thymic AC. The patient underwent abdominal lymph node resection and distal pancreatectomy in June 2014. Because the lymph node on the ventral side of the branchiocephalic vein was judged as unresectable, 60-Gy radiation therapy was given in September 2014. Per pathological examination and immunohistochemistry, the final diagnosis was pancreatic metastasis of thymic AC. With several chemotherapy courses for recurrences, the patient has remained alive for eight years after the first surgery. Conclusion: AC metastasis to the pancreas is extremely rare. EUS-FNA is useful for diagnosis. Definitive determination of whether the treatment provides a survival benefit awaits further studies.

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Section: Discussionmentioning

confidence: 99%

A Case of Distal Pancreatectomy for Pancreatic Metastasis of Thymic Atypical Carcinoid

Inoue¹,

Tanemura²,

Irei³

et al. 2017

AJMCR

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“…This occurred in almost 46% of our patients. On Arq Gastroenterol 13 pancreatic head (1,6,21) . These tumors are symptomatic in 15% to 53% of the cases due to secretion of biologically active substances.…”

Section: Discussionmentioning

confidence: 99%

Pancreatic Splenosis Mimicking Neuroendocrine Tumors:

Ardengh¹,

Lopes

Kemp

et al. 2013

Arq. Gastroenterol.

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-Context -Pancreatic splenosis is a benign condition which can mimic a pancreatic neoplasm. Objective -To describe the role of the endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic nodules suspicious for pancreatic splenosis. Method -From 1997 to 2011, patients with pancreatic solid tumors suspicious for splenosis by computed tomography and/or magnetic resonance imaging were referred to EUS-FNA. Those cases with pancreatic splenosis confirmed by EUS-FNA or surgery were included. Endosonographic findings and clinicopathologic features were also analysed. Results -A total of 2,060 patients with pancreatic solid tumors underwent EUS-FNA. Fourteen (0.6%) cases with pancreatic splenosis were found. After applying exclusion criteria, 11 patients were selected. Most patients were male (7), young (mean age: 42 years) and asymptomatic (8). Endoscopic ultrasound imaging alone suspected pancreatic splenosis in 6 cases, and neuroendocrine tumors in 5 cases. Pancreatic splenosis was found most commonly in the tail, was round, hypoechoic, with homogeneous pattern, regular borders, and with scintigraphy negative for somatostatin receptors. The average diameter of these nodules identified by endoscopic ultrasound was 2.15 cm. Microhistology obtained by EUS-FNA confirmed the diagnosis in 9/10 patients. Conclusion -Pancreatic splenosis can be diagnosed by EUS-FNA. Microhistology prevents unnecessary surgeries, and reassures asymptomatic patients with hypoechoic, homogeneous, and well circumscribed pancreatic nodules.

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“…In a relatively large prospective trial evaluating the use of EUS, Anderson et al found a sensitivity of 93% in detecting pancreatic tumors with a mean tumor diameter of 1.51 cm [13]. Furthermore, EUS has showed the added utility of allowing fine needle aspiration to distinguish visualized masses further aiding in diagnosis, staging, and in determining a management strategy [14,15].…”

Section: Diagnosismentioning

confidence: 99%

Vasoactive Intestinal Peptide Tumor

Natanzi

Amini

Yamini

et al. 2009

Scholarly Research Exchange

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Background and aim. Vasoactive intestinal peptide tumor is a rare neuroendocrine neoplasm which causes voluminous watery diarrhea via hypersecretion of electrolytes and water from the intestinal mucosa through a vasoactive intestinal peptide-mediated, cyclic AMP-dependent mechanism. The acid base imbalance generated by the loss of water and electrolytes leads to severe dehydration and potential renal failure, which can ultimately result in death if left untreated. This paper aims to review the clinical, histological, radiological, and diagnostic features of this disease as well as the therapeutic modalities in treating this condition. Methods. A review of literature was performed using MEDLINE, Pubmed, and Cochrane databases in collection of data using MeSH terms including vasoactive intestinal peptide, VIPoma, and WDHA. Results and conclusion. Vasoactive intestinal peptide tumor is a rare neoplasm associated with significant morbidity and mortality through secretion of water and electrolytes in the gastrointestinal tract. The nonspecific clinical presentation of this neoplasm can pose diagnostic challenges, as these tumors can be easily misdiagnosed as other conditions, ranging from laxative overdose to the presence of a carcinoid secreting tumor. Nevertheless, a number of imaging and laboratory studies can facilitate the correct evaluation and diagnosis of VIPoma. Following proper diagnosis, VIPomas are treated by either medical or surgical modalities depending on the existence and extent of metastasis.

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EUS-guided FNA in the diagnosis of pancreatic neuroendocrine tumors before surgery

Cited by 109 publications

References 23 publications

A Case of Distal Pancreatectomy for Pancreatic Metastasis of Thymic Atypical Carcinoid

A Case of Distal Pancreatectomy for Pancreatic Metastasis of Thymic Atypical Carcinoid

Pancreatic Splenosis Mimicking Neuroendocrine Tumors:

Vasoactive Intestinal Peptide Tumor

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