Abstract
The place of endoscopic ultrasound (EUS) is fundamental in neuroendocrine tumors of the gastrointestinal (GI) tract, and indeed EUS is themost performed examination for the diagnosis of location of these tumors. All the data of the literature shows that the EUS is superior to the other conventional techniques as the percutaneous echography, the helical scanner, and the magnetic resonance imaging (MRI). Besides, the development of the EUSguided fine-needle aspiration (FNA) allows to confirm by cytology the diagnosis carried out by EUS imaging. It is advisable to differentiate the well-differentiated neuroendocrine tumor (NET), where the indication of the EUS is done in front of an endocrine syndrome (hypoglycemia, hypergastrinemia, diarrhea), from the undifferentiated and non secretant pancreatic NET, where the indication of the EUS ismade in front of a pancreatic mass or more often in front of prevalent liver metastasis without primary lesion.
Résumé
La place de l’échoendoscopie (EE) dans le diagnostic des tumeurs neuroendocrines (TNE) du pancréas est fondamentale; en effet, l’EE est l’examen le plus performant pour le diagnostic de localisation de ces tumeurs. L’ensemble des données de la littérature montre que l’EE est supérieure aux autres techniques conventionnelles comme l’échographie percutanée, le scanner hélicoïdal et l’IRM. Par ailleurs, le développement de la biopsie guidée sous EE permet de confirmer cytologiquement le diagnostic porté par l’image échoendoscopique. Il convient de différencier les TNE pancréatiques bien différenciées où l’indication de l’EE est posée devant un syndrome endocrinien (hypoglycémie, hypergastrinémie, diarrhée) des TNE pancréatiques peu différenciées et non sécrétantes où l’indication de l’EE est posée devant un syndrome de masse tumorale pancréatique ou plus souvent devant la recherche d’une lésion primitive pancréatique chez un patient présentant des métastases viscérales (hépatiques le plus souvent) sans primitif retrouvé.
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Giovannini, M., Monges, G. Échoendoscopie et tumeurs neuroendocrines du pancréas. Oncologie 15, 520–523 (2013). https://doi.org/10.1007/s10269-013-2334-2
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DOI: https://doi.org/10.1007/s10269-013-2334-2