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

• Published in: Digestive diseases and sciences 2012-03, Vol.57 (3), p.791-800
• Main Authors: Atiq, Muslim, Bhutani, Manoop S., Bektas, Mehmet, Lee, Jeffrey E., Gong, Yun, Tamm, Eric P., Shah, Chintan P., Ross, William A., Yao, James, Raju, Gottumukkala S., Wang, Xuemei, Lee, Jeffrey H.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Biochemistry; Biopsy, Fine-Needle - methods; Cancer Care Facilities; Databases, Factual; Endosonography - methods; Female; Gastroenterology; Hepatology; Humans; Insulinoma - diagnostic imaging; Insulinoma - pathology; Kaplan-Meier Estimate; Male; Medicine; Medicine & Public Health; Middle Aged; Multiple Endocrine Neoplasia Type 1 - diagnostic imaging; Multiple Endocrine Neoplasia Type 1 - pathology; Neuroendocrine Tumors - diagnostic imaging; Neuroendocrine Tumors - pathology; Oncology; Original Article; Pancreatic Neoplasms - diagnostic imaging; Pancreatic Neoplasms - pathology; Tomography, X-Ray Computed - methods; Transplant Surgery; Young Adult
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-011-1912-7

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.