Endoscopic ultrasonography coupled with fine needle aspiration biopsy of intraductal papillary-mucinous tumours of the pancreas. Tool or gadget? A report of three cases

Chir Ital. 2007 Jul-Aug;59(4):489-94.

Abstract

We report three cases of intraductal papillary-mucinous tumour of the pancreas, occurring over a brief period in our surgical unit. Symptoms were aspecific in two cases, while only one of the patients presented a picture of acute pancreatitis. Preoperative investigations included ultrasonography, abdominal CT-scan and endoscopic ultrasonography (EUS) with guided fine needle aspiration biopsy (EUS-FNAB) of the cyst. EUS furnished invaluable data about the neoplasm and pancreatic duct morphology, while EUS-FNAB was crucial in revealing cytological features highly suggestive of intraductal papillary-mucinous tumour. All three patients underwent surgical resection, (two pylorus-preserving pancreatico-duodenectomies and one total pancreatectomy). The histological features of the resected specimen confirmed the preoperative EUS-FNAB diagnosis. After a medium-term follow-up, patients have been free of abdominal symptoms with no evidence of recurrence at CT-scan. In the present study we analyse the feasibility and effectiveness of EUS and EUS-FNAB in diagnosing intraductal papillary-mucinous tumours and in predicting their malignancy.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma, Mucinous / diagnostic imaging
  • Adenocarcinoma, Mucinous / pathology
  • Aged
  • Biopsy, Fine-Needle / methods*
  • Carcinoma, Pancreatic Ductal / diagnosis
  • Carcinoma, Pancreatic Ductal / diagnostic imaging*
  • Carcinoma, Pancreatic Ductal / pathology*
  • Carcinoma, Pancreatic Ductal / surgery
  • Carcinoma, Papillary / diagnostic imaging
  • Carcinoma, Papillary / pathology
  • Endosonography*
  • Humans
  • Male
  • Pancreatectomy
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / diagnostic imaging*
  • Pancreatic Neoplasms / pathology*
  • Pancreatic Neoplasms / surgery
  • Predictive Value of Tests
  • Sensitivity and Specificity
  • Treatment Outcome