Endoscopic ultrasonography coupled with fine needle aspiration biopsy of intraductal papillary-mucinous tumours of the pancreas. Tool or gadget? A report of three cases.
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.
Barabino
Matteo
M
Hepatobiliary Surgery Unit, San Paolo Hospital, University School of Medicine, Milan.
Santambrogio
Roberto
R
Pisani
Andrea
A
Leone
Sara
S
Carrara
Silvia
S
Opocher
Enrico
E
D002288:Adenocarcinoma, Mucinous / Q000000981:diagnostic imaging / Q000473:pathology; D000368:Aged; D044963:Biopsy, Fine-Needle / Q000379:methods*; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging / Q000473:pathology; D019160:Endosonography; D006801:Humans; D008297:Male; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D016896:Treatment Outcome