Is EUS-FNA of solid-pseudopapillary neoplasms of the pancreas as a preoperative procedure really necessary and free of acceptable risks?

Abstract Background Solid-pseudopapillary neoplasms (SPNs) of the pancreas are infrequent tumors since, as of 2014, only 2744 patients have been described. Its rarity, unclear histogenesis, pleomorphic aspect on radiology (cystic, solid or mixed) and unpredictable biological behavior with an insidio...

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Published in:Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 2014-11, Vol.14 (6), p.536-538
Main Authors: Virgilio, Edoardo, Mercantini, Paolo, Ferri, Mario, Cunsolo, Gaetano, Tarantino, Giulia, Cavallini, Marco, Ziparo, Vincenzo
Format: Article
Language:English
Subjects:
Abdomen
Adult
Biopsy
Biopsy - adverse effects
Biopsy - methods
Carcinoma, Papillary - diagnosis
Carcinoma, Papillary - pathology
Carcinoma, Papillary - surgery
Cysts
Endocrinology & Metabolism
Endoscopic Ultrasound-Guided Fine Needle Aspiration - adverse effects
Endoscopic Ultrasound-Guided Fine Needle Aspiration - methods
EUS-FNA
Female
Gastroenterology and Hepatology
Humans
Medical imaging
Neoplasm Seeding
Pancreatectomy
Pancreatic cyst
Pancreatic Neoplasms - diagnosis
Pancreatic Neoplasms - pathology
Pancreatic Neoplasms - surgery
Patients
Peritoneal recurrence
Peritoneal seeding
Preoperative Care
Risk
Rupture
SPN
Staphylococcal Infections - etiology
Tumor rupture
Tumors
Ultrasonic imaging
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Summary:Abstract Background Solid-pseudopapillary neoplasms (SPNs) of the pancreas are infrequent tumors since, as of 2014, only 2744 patients have been described. Its rarity, unclear histogenesis, pleomorphic aspect on radiology (cystic, solid or mixed) and unpredictable biological behavior with an insidious high-grade malignant potential make SPN difficult to recognize preoperatively even in its target patient population which is predominantly composed of young women (about 87% of cases). Methods Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) showed to improve the preoperative diagnostic yield for this tumor and obviate the risks formerly given by percutaneous biopsy. Results In light of our experience, such a procedure could not be so innocuous as generally acknowledged. Conclusion We report the first case of rupture of pancreatic SPN following EUS-FNA and entertain both the actual and potential complications ensuing from this type of mishap.
ISSN:1424-3903
1424-3911
DOI:10.1016/j.pan.2014.08.004