title: Extraparietal or lymphatic late relapse of neoplasms: confirmation by means of EUS-FNA key for the treatment.
abstract: BACKGROUND
  After treatment intended to cure systemic neoplasms, a series of monitoring strategies are followed.
  
  
  OBJECTIVE
  To analyse our experience in confirming the cases of lymphatic or extraparietal relapse in areas accessible to endoscopic ultrasonography plus fine-needle aspiration (EUS-FNA) in long-term monitoring (>1 year of treatment for the primary neoplasm) and define what implications have been derived with regards histopathological confirmation in relation to treatment.
  
  
  METHODS
  Retrospective analysis was made of all EUS-FNA carried out in our Endoscopy Unit during the period from 1/07/2007 to 28/02/2010 by means of searches in the Endobase (Olympus) database. Medical records of patients and drug therapy were reviewed in order to check the chemotherapy used in each case.
  
  
  RESULTS
  From a total of 154 EUS-FNA carried out in our service, we have detected histopathological confirmation of malignancy in primary neoplasm treated with initial curative intention at least 1 year before. Locations were: esophageal extraparietal involvement of a squamous cell carcinoma (one patient), perirectal adenopathy of rectal adenocarcinoma (one patient), multiple lymphatic relapse of melanoma (two patients), perigastric adenopathy relapse of gastric adenocarcinoma (one patient), pancreatic head mass secondary to initial breast ductal carcinoma (one patient). In all cases, this fact has involved a directed treatment: surgery (one patient), radiotherapy (one patient), chemotherapy (four patients).
  
  
  CONCLUSIONS
  Confirmation by means of EUS-FNA of late relapse in any section of the digestive tract allowed a treatment to be carried out by surgery, radiotherapy, or chemotherapy.
authors.affiliation: Digestive Disease Service, Complexo Hospitalario de Pontevedra, Pontevedra, Spain. joseluisulla@gmail.com
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Ulla-Rocha
authors.forename: Zenaida
authors.initials: Z
authors.lastname: Vilar-Cao
authors.forename: Monica
authors.initials: M
authors.lastname: Alvarez-Martinez
authors.forename: Laura
authors.initials: L
authors.lastname: Salgado-Boquete
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000556:secondary / Q000628:therapy; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008206:Lymphatic Diseases / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000628:therapy; D009367:Neoplasm Staging; D009369:Neoplasms / Q000473:pathology* / Q000628:therapy; D010190:Pancreatic Neoplasms / Q000556:secondary* / Q000628:therapy; D011379:Prognosis; D012004:Rectal Neoplasms / Q000556:secondary* / Q000628:therapy; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000556:secondary* / Q000628:therapy