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

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Abstract

Objectives

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.

Methods

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.

Results

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).

Conclusion

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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Authors and Affiliations

  1. Department of Gastroenterology, MD Anderson Cancer Center, 1515-Holcombe Blvd., Unit #1466, Houston, TX, 77030, USA

    Muslim Atiq, Manoop S. Bhutani, Mehmet Bektas, Chintan P. Shah, William A. Ross, Gottumukkala S. Raju & Jeffrey H. Lee

  2. Department of Surgical Oncology, MD Anderson Cancer Center, Houston, TX, USA

    Jeffrey E. Lee

  3. Department of Pathology, MD Anderson Cancer Center, Houston, TX, USA

    Yun Gong

  4. Department of Radiology, MD Anderson Cancer Center, Houston, TX, USA

    Eric P. Tamm

  5. Department of Medical Oncology, MD Anderson Cancer Center, Houston, TX, USA

    James Yao

  6. Department of Biostatistics, MD Anderson Cancer Center, Houston, TX, USA

    Xuemei Wang

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  1. Muslim Atiq
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Correspondence to Jeffrey H. Lee.

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Atiq, M., Bhutani, M.S., Bektas, M. et al. EUS-FNA for Pancreatic Neuroendocrine Tumors: A Tertiary Cancer Center Experience. Dig Dis Sci 57, 791–800 (2012). https://doi.org/10.1007/s10620-011-1912-7

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  • DOI: https://doi.org/10.1007/s10620-011-1912-7

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