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modality in the diagnosis of pancreatic cystic lesions (PCL). To determine the frequency of malignancy and potentially malignancy in small (Ͻ 3 cm) incidental pancreatic cyst (IPC) and compare with symptomatic pancreatic cysts (PCL). Methods: Patients referred for EUS-FNA for evaluation of pancreatic cysts were recruited prospectively between Aug/04 and Aug/09 at a Tertiary Referral Centre (Hospital 9 de Julho). Presence or absence of symptoms, cyst size and location, cell block or pathologic diagnosis, surgical treatment, and outcome were measured. Were selected only patients with cysts smaller than 3.0cm detected by EUS. Results: One hundred and fifty-five (51.3%) patients had cysts smaller than 3.0cm of 302 patients with pancreatic cyst. 112 (72%) were asymptomatic (IPC) and 43 (28%) symptomatic (PCL). IPC were more prevalent in women (76% vs. 49%) and no difference was observed between age (median 57yrs (range 11-86)). Sixty-five percent of the asymptomatic patients and 44% of those with symptoms underwent surgery, with a two operative dead in the entire group (1.2%). 87 (56.4%) patients had benign cysts, 61 were IPC and 26 PCL (p Ͻ0.001). Thirty-two percent of IPC were serous cystadenoma; 26.5%, intraductal papillary mucinous tumor (adenoma (25), invasive (3) and ca in situ (2)); and 9.5% mucinous cystic neoplasms (invasive (7)). The respective numbers for PCL were 4.7%, 21.3% and 0%. Twenty-two percent of IPC and 11.9% of symptomatic patients had a variety of other pancreatic cysts. Overall 10.5% of IPC had in situ or invasive cancer, 27.4% had a premalignant lesion; and 8% had a malignant precursors lesion (PanIN 1 (7) and PanIN 2 (2)). The respective numbers for PCL were 21.5%; 14.2%; and 2.3%. Pseudocysts comprised only 1.7% of IPC compared with 50% of symptomatic patients (pϽ0.001). Conclusions: Incidental pancreatic cysts smaller than 3.0 cm are common. More than half of them were benign, often occurs in women and are unlikely to be pseudocysts. Approximately half are premalignant, malignant or precursors lesions of the pancreatic cancer and therefore cannot be dismissed.Background and Aims: Endoscopic submucosal dissection (ESD) has been developed for superficial esophageal neoplasm in Japan, because ESD enables large en-bloc resection. En-bloc resection for GI tract lesion is desirable to facilitate accuracy of the histopathological assessment. The aim of this study was to compare the long-term outcomes between ESD and endoscopic aspiration mucosectomy (EAM) for esophageal squamous cell neoplasm.Methods: Between February 2001 and March 2009, a total of 82 patients with esophageal squamous cell neoplasm were treated by ESD or EAM at our institutions. The mean resected size, en-bloc resection rate, histopathological findings, and complications were compared. After initial treatment, all cases were observed (mean period: 37.2 months, range: 8-103 months), and the local recurrence rate and overall survival period of each group were analyzed.Results: Sixty-one patients were treated by ESD (57 males, media...