Digestive Diseases and Sciences

, Volume 57, Issue 3, pp 791–800

EUS-FNA for Pancreatic Neuroendocrine Tumors: A Tertiary Cancer Center Experience


  • Muslim Atiq
    • Department of GastroenterologyMD Anderson Cancer Center
  • Manoop S. Bhutani
    • Department of GastroenterologyMD Anderson Cancer Center
  • Mehmet Bektas
    • Department of GastroenterologyMD Anderson Cancer Center
  • Jeffrey E. Lee
    • Department of Surgical OncologyMD Anderson Cancer Center
  • Yun Gong
    • Department of PathologyMD Anderson Cancer Center
  • Eric P. Tamm
    • Department of RadiologyMD Anderson Cancer Center
  • Chintan P. Shah
    • Department of GastroenterologyMD Anderson Cancer Center
  • William A. Ross
    • Department of GastroenterologyMD Anderson Cancer Center
  • James Yao
    • Department of Medical OncologyMD Anderson Cancer Center
  • Gottumukkala S. Raju
    • Department of GastroenterologyMD Anderson Cancer Center
  • Xuemei Wang
    • Department of BiostatisticsMD Anderson Cancer Center
    • Department of GastroenterologyMD Anderson Cancer Center
Original Article

DOI: 10.1007/s10620-011-1912-7

Cite this article as:
Atiq, M., Bhutani, M.S., Bektas, M. et al. Dig Dis Sci (2012) 57: 791. doi:10.1007/s10620-011-1912-7



Pancreatic neuroendocrine tumors (PNET) are fairly uncommon. Recent data highlight the importance of EUS in diagnosis of PNET. With this background, we decided to review our experience from a tertiary cancer center with regard to the presentation and clinical features of PNET and the diagnostic utility of EUS-FNA in this scenario.


We identified patients who underwent EUS at our institution between January 1st 2001 and December 31st 2009 for a suspected PNET. Data on clinical features, cross-sectional imaging findings, EUS findings, and cytology results were collected.


A total of 81 patients were referred for EUS-FNA for a suspected PNET. Mean age was 58.1 years. There were 41 (50.6%) males. PNET was found incidentally in 38 (46.9%) patients. Computed tomography scanning identified a pancreatic mass in 72 out of 79 (91.1%) cases. Mean diameter of the largest lesion seen on EUS was 27.5 mm (range: 6.9–80 mm). The most common site (34; 42%) was the head of the pancreas. EUS-FNA correctly confirmed a PNET in 73 out of 81 cases with diagnostic accuracy of 90.1%. Seven (8.6%) out of 81 patients had functional lesions, including three gastrinomas and four insulinomas. Liver metastases were found in 31 out of 81 (38.3%) cases. Of the 31 patients with liver metastasis, the mean diameter of lesions on EUS was 33.9 mm compared with 23.5 mm in patients without liver metastasis (P = 0.005).


EUS-FNA is a reliable modality for further characterization of suspected lesions and for establishing a tissue diagnosis. The occurrence of complications of EUS-FNA in this setting is low. Non-functional PNET are more frequently encountered than functional PNET.


Pancreatic neuroendocrine tumors Endoscopic ultrasound Fine needle aspiration MEN-1 Insulinomas

Copyright information

© Springer Science+Business Media, LLC 2011