Endoscopic ultrasound delivery of an antitumor agent to treat a case of pancreatic cancer.
BACKGROUND
A 72-year-old white male presented to a University Digestive Disease Center with epigastric pain and weight loss. A CT scan suggested that the patient had a mass in his pancreas and he was referred for further diagnostic work-up, staging and treatment.


METHODS
Endoscopic ultrasound (EUS), EUS-guided fine-needle aspiration.


METHODS
Locally advanced, unresectable adenocarcinoma of the pancreas.


RESULTS
Opioid analgesics and EUS-guided celiac neurolysis (transgastric injection of bupivacaine and alcohol on both sides of the celiac artery) for pain relief. Five once-weekly intratumoral injections of TNFerade (GenVec, Inc., Gaithersburg, MD) by EUS-guided fine needle injection, in combination with chemoradiation (5 FU/XRT), as part of a multicenter clinical trial. Repeat fine-needle aspiration followed by surgical resection of the tumor.
Chang
Kenneth J
KJ
Comprehensive Digestive Disease Center, University of California, Irvine Medical Center, Room 106, First Floor, Building 22C, 101 The City Drive, Orange, CA 92868-3298, USA. kchang@uci.edu
Lee
John G
JG
Holcombe
Randall F
RF
Kuo
Jeffrey
J
Muthusamy
Raman
R
Wu
Mark L
ML
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D044963:Biopsy, Fine-Needle; D019160:Endosonography / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional / Q000379:methods; D008297:Male; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*
D000970:Antineoplastic Agents