EUS-FNA for Pancreatic Neuroendocrine Tumors: A Tertiary Cancer Center Experience
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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.
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- EUS-FNA for Pancreatic Neuroendocrine Tumors: A Tertiary Cancer Center Experience
Digestive Diseases and Sciences
Volume 57, Issue 3 , pp 791-800
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Pancreatic neuroendocrine tumors
- Endoscopic ultrasound
- Fine needle aspiration
- Industry Sectors
- Author Affiliations
- 1. Department of Gastroenterology, MD Anderson Cancer Center, 1515-Holcombe Blvd., Unit #1466, Houston, TX, 77030, USA
- 2. Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX, USA
- 3. Department of Pathology, MD Anderson Cancer Center, Houston, TX, USA
- 4. Department of Radiology, MD Anderson Cancer Center, Houston, TX, USA
- 5. Department of Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA
- 6. Department of Biostatistics, MD Anderson Cancer Center, Houston, TX, USA