We appreciate the interest of Dr. LØvy and colleagues [1] in our report [2]. We agree that endoscopic ultrasound−guided fine− needle aspiration (EUS−FNA) should be performed to direct clinical management, meaning FNA results will affect surgical decision making. Our purpose in publish− ing this multicenter experience was two− fold: (i) to increase awareness in the EUS community of this very rare entity, the solid pseudopapillary tumor (SPT), and (ii) to evaluate, we emphasize, the diag− nostic accuracy of EUS−FNA in making a definitive diagnosis, as compared to sur− gical pathology. The key word here is "di− agnostic." No patient in the series was re− ferred with a pre−EUS suspicion of an SPT, and SPT was included in the differential diagnosis on the EUS report in only 50 % of cases in our series. Thus it was consid− ered, but not necessarily suspected. This tumor is frequently misdiagnosed as a neuroendocrine tumor preoperatively. In the study by Bardeles et al., 50 % of the cases were diagnosed as neuroendocrine tumors based upon the EUS appearance [3]. In our series, five patients were diag− nosed with neuroendocrine tumors by EUS−FNA cytology and immunostaining (as immunostains specific for SPT were not performed). Hence, our purpose here− in of increasing awareness and recom− mending immunostain profiles when this lesion is considered, which will in− crease the diagnostic accuracy. Regarding the influencing of surgical de− cision making, one could argue that a dif− ferential diagnosis of neuroendocrine tu− mor vs SPT is moot, as recommendations are to resect both. However, in the era of minimally invasive surgical approaches, a definitive preoperative diagnosis can in− fluence decision making. Indeed, in our series, laparoscopic distal pancreatect− omy was performed in 29 % based upon the definitive preoperative diagnosis. Our recent series reporting EUS−FNA re− sults of nonfunctioning neuroendocrine tumors had a similar conclusion: defini− tive preoperative diagnosis led to a la− paroscopic approach in 34 % of cases [4]. As physicians, don't we owe it to our pa− tients to recommend the least morbid treatment? And the other often forgotten factor is that patients, at least in our neck of the woods, want to know their diagno− sis before undergoing a surgery that can carry a significant morbidity. This brings us to the safety of the proce− dure. There were no complications relat− ed to the EUS−FNA procedure in our ser− ies, thus it is a safe procedure. LØvy et al.[1] infer that our procedures were not "safe" given our short follow−up period. They insinuate that EUS−FNA will lead to peritoneal seeding, equating the FNA pro− cedure (with a 22− or 25−g needle) to "ab− dominal trauma" [5]. In the much more prevalent scenario of pancreatic cancer, tumor seeding has always been a con− cern. EUS−FNA has been found to be a much "safer" approach compared with percutaneous biopsy, with a far smaller incidence of tumor seeding [6]. In the case of EUS−FNA of pancreatic head tu− mors (25 % of our SPT series), the needle p...