EUS diagnosis of cystic pancreatic neuroendocrine tumors

Li-Geng, Tony; Cai, Guoping; Aslanian, Harry R.

doi:10.1016/j.vgie.2017.12.007

Cited by 4 publications

(2 citation statements)

References 13 publications

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“…There is limited information on Octreoscan or Gallium-labeled somatostatin analog positron emission tomography applied to pancreatic NET, which are only useful for poorly differentiated lesions. When visualized using EUS, cystic pNETs present thick walls and septa and allow for the aspiration of the cyst fluid and its analysis [ 21 , 22 ]. The corresponding treatment consists of surgery for lesions over 2 cm, for which tumor location is also considered.…”

Section: Where Do We Stand On Pancreatic Cystic Lesions?mentioning

confidence: 99%

Real-Life Management of Pancreatic Cysts: Simplified Review of Current Guidelines

Vlăduţ

Bilous

Ciocîrlan

2023

JCM

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Pancreatic cysts are becoming a popular diagnostic tool due to the increased availability of high-quality cross-sectional imaging. Pancreatic cystic lesions constitute closed, liquid-containing cavities, which are either neoplastic or non-neoplastic. While serous lesions often follow a benign course, mucinous lesions can hide carcinoma and, therefore, require different management. Moreover, all cysts should be considered mucinous until proven otherwise, thus limiting the errors in managing these entities. Due to the need for high contrast soft tissue imaging, magnetic resonance imaging represents an elective, non-invasive diagnostic tool. Endoscopic ultrasound (EUS) has started gaining more prominence with regard to the proper diagnosis and management of pancreatic cysts, offering quality information with minimal risks. Enabling both the acquisition of endoscopic images of the papilla and the endosonographic high-quality evaluation of septae, mural nodules along with the vascular patterns of the lesion contribute to a definitive diagnosis. Moreover, the possibility of obtaining cytological or histological samples could become mandatory in the foreseeable future, allowing for more precise molecular testing. Future research should focus on detecting methods to quickly diagnose high-grade dysplasia or early cancer for patients with pancreatic cysts, thus allowing time for appropriate treatment and avoiding surgical overtreatment or over surveillance in selected cases.

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Section: Where Do We Stand On Pancreatic Cystic Lesions?mentioning

confidence: 99%

Real-Life Management of Pancreatic Cysts: Simplified Review of Current Guidelines

Vlăduţ

Bilous

Ciocîrlan

2023

JCM

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“…Sensitivity of EUS-FNA for cystic PNENs is lower than solid PNENs [18]. The cyst wall and septations should be targeted with FNA to maximize cytologic diagnosis [19].…”

Section: Cystic Degenerationmentioning

confidence: 99%

Role of Endoscopic Ultrasound in the Diagnosis of Pancreatic Neuroendocrine Neoplasms

Ishii

Katanuma

Toyonaga

et al. 2020

Preprint

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Although pancreatic neuroendocrine neoplasms (PNENs) are relatively rare tumors, their number is increasing with advances in diagnostic imaging modalities. Even small lesions that are difficult to detect using computed tomography or magnetic resonance imaging can be detected with endoscopic ultrasound (EUS). Contrast-enhanced EUS is useful, and not only diagnosis but also malignancy detection have become possible by evaluating the vascularity of tumors. Pathological diagnosis using EUS with fine-needle aspiration (EUS-FNA) is useful when diagnostic imaging is difficult. EUS-FNA can also evaluate the grade of malignancy. Pooling the data of the studies which compared the PNENs grading between EUS-FNA samples and surgical specimen, the concordance rate was 77.5% (κ-statistic: 0.65, 95% confidence interval = 0.59 - 0.71, P< 0.01). EUS is a particularly important modality for the treatment of PNENs.

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