title: Is EUS-FNA of solid-pseudopapillary neoplasms of the pancreas as a preoperative procedure really necessary and free of acceptable risks?
abstract: BACKGROUND
  Solid-pseudopapillary neoplasms (SPNs) of the pancreas are infrequent tumors since, as of 2014, only 2744 patients have been described. Its rarity, unclear histogenesis, pleomorphic aspect on radiology (cystic, solid or mixed) and unpredictable biological behavior with an insidious high-grade malignant potential make SPN difficult to recognize preoperatively even in its target patient population which is predominantly composed of young women (about 87% of cases).
  
  
  METHODS
  Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) showed to improve the preoperative diagnostic yield for this tumor and obviate the risks formerly given by percutaneous biopsy.
  
  
  RESULTS
  In light of our experience, such a procedure could not be so innocuous as generally acknowledged.
  
  
  CONCLUSIONS
  We report the first case of rupture of pancreatic SPN following EUS-FNA and entertain both the actual and potential complications ensuing from this type of mishap.
authors.affiliation: Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology "Sapienza", St. Andrea Hospital, via di Grottarossa 1035-39, Rome 00189, Italy. Electronic address: aresedo1992@yahoo.it.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Virgilio
authors.affiliation: Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology "Sapienza", St. Andrea Hospital, via di Grottarossa 1035-39, Rome 00189, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Mercantini
authors.affiliation: Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology "Sapienza", St. Andrea Hospital, via di Grottarossa 1035-39, Rome 00189, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Ferri
authors.affiliation: Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology "Sapienza", St. Andrea Hospital, via di Grottarossa 1035-39, Rome 00189, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Cunsolo
authors.affiliation: Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology "Sapienza", St. Andrea Hospital, via di Grottarossa 1035-39, Rome 00189, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Tarantino
authors.affiliation: Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology "Sapienza", St. Andrea Hospital, via di Grottarossa 1035-39, Rome 00189, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Cavallini
authors.affiliation: Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology "Sapienza", St. Andrea Hospital, via di Grottarossa 1035-39, Rome 00189, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ziparo
mesh_terms: D000328:Adult; D001706:Biopsy / Q000009:adverse effects / Q000379:methods; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D009366:Neoplasm Seeding; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology* / Q000601:surgery; D011300:Preoperative Care; D012306:Risk; D012421:Rupture; D013203:Staphylococcal Infections / Q000209:etiology
keywords: EUS-FNA; Pancreatic cyst; Peritoneal recurrence; Peritoneal seeding; SPN; Tumor rupture