title: EUS-FNA for pancreatic neuroendocrine tumors: a tertiary cancer center experience.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Gastroenterology, MD Anderson Cancer Center, 1515-Holcombe Blvd., Unit #1466, Houston, TX 77030, USA.
authors.forename: Muslim
authors.initials: M
authors.lastname: Atiq
authors.forename: Manoop S
authors.initials: MS
authors.lastname: Bhutani
authors.forename: Mehmet
authors.initials: M
authors.lastname: Bektas
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Lee
authors.forename: Yun
authors.initials: Y
authors.lastname: Gong
authors.forename: Eric P
authors.initials: EP
authors.lastname: Tamm
authors.forename: Chintan P
authors.initials: CP
authors.lastname: Shah
authors.forename: William A
authors.initials: WA
authors.lastname: Ross
authors.forename: James
authors.initials: J
authors.lastname: Yao
authors.forename: Gottumukkala S
authors.initials: GS
authors.lastname: Raju
authors.forename: Xuemei
authors.initials: X
authors.lastname: Wang
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle / Q000379:methods*; D002173:Cancer Care Facilities; D016208:Databases, Factual; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D007340:Insulinoma / Q000000981:diagnostic imaging / Q000473:pathology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D018761:Multiple Endocrine Neoplasia Type 1 / Q000000981:diagnostic imaging / Q000473:pathology; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult