Endoscopic ultrasound features of familial vs sporadic pancreatic neuroendocrine tumours: a single-centre retrospective study

BACKGROUND: Endoscopic ultrasound (EUS) is accurate in diagnosing pancreatic neuroendocrine tumours (PNETs), but its impact on surgical management is unclear.OBJECTIVE: To determine whether preoperative EUS findings altered the decision for, and extent of, surgery in patients with PNETs.METHODS: A retrospective review of patients referred for EUS because of suspected PNETs was conducted. The diagnosis of PNETs was confirmed by EUS-guided fine needle aspiration cytology, where indicated, or by surgical histology. EUS findings were compared with computed tomography (CT) findings to determine whether there was an impact on the decision for surgical management.RESULTS: Fourteen patients (10 women), with a mean age of 44 years, underwent EUS for suspected PNETs. PNETs were seen with CT in 10 of 13 patients (77%) and with EUS in 14 of 14 patients (100%). One obese patient could not fit into the CT scanner. This patient had five PNETs on EUS. Three patients with a normal CT scan were determined to have one or two PNETs on EUS. Three patients with one or two PNETs on CT were found to have five to eight PNETs on EUS. EUS altered the decision for possible surgical management in five of 14 patients (36%), either by identifying a PNET or by finding multiple and multifocal PNETs that were not visualized on CT scans.CONCLUSION: EUS is useful in the preoperative assessment of PNETs by providing information that significantly influences the decision for surgical intervention or changes the extent of the planned surgery.

Download Full-text

pNETs (Pancreatic Neuroendocrine tumours) in MEN1 (Multiple Endocrine Neoplasia): a single centre case series

Endocrine Abstracts ◽

10.1530/endoabs.68.p7 ◽

2019 ◽

Author(s):

Hema Venkataraman ◽

Stacey Smith ◽

Suzanne Vickrage ◽

Joanne Kemp-Blake ◽

Ian Geh ◽

...

Keyword(s):

Multiple Endocrine Neoplasia ◽

Neuroendocrine Tumours ◽

Case Series ◽

Single Centre ◽

Endocrine Neoplasia ◽

Pancreatic Neuroendocrine Tumours

Download Full-text

Pancreatic Neuroendocrine Tumours: The Role of Endoscopic Ultrasound Biopsy in Diagnosis and Grading Based on the WHO 2017 Classification

Digestive Diseases ◽

10.1159/000499172 ◽

2019 ◽

Vol 37 (4) ◽

pp. 325-333 ◽

Cited By ~ 7

Author(s):

Milena Di Leo ◽

Laura Poliani ◽

Daoud Rahal ◽

Francesco Auriemma ◽

Andrea Anderloni ◽

...

Keyword(s):

Endoscopic Ultrasound ◽

Neuroendocrine Tumours ◽

Histological Grade ◽

Accurate Method ◽

Biopsy Material ◽

Ki 67 ◽

Surgical Specimen ◽

Study Population ◽

Pancreatic Neuroendocrine Tumours

Background: One of the controversial issues in the diagnosis of pancreatic neuroendocrine tumours (pNETs) is the accurate prediction of their clinical behaviour. Objectives: The aim of the study was to evaluate the role of endoscopic ultrasound (EUS) biopsy in the diagnosis and grading of pNETs in a certified ENETS Center. Methods: A prospectively maintained database of EUS biopsy procedures was retrospectively reviewed to identify all consecutive patients referred to a certified ENETS Center with a suspicion of pNET between June 2014 and April 2017. The cytological and/or histological specimens were stained and the Ki-67 labeling index was evaluated. In patients undergoing surgery, the grade obtained with EUS-guided biopsy was compared with the final histological grade. The grade was evaluated according to the 2017 WHO classifications and grading. Results: The study population included 59 patients. EUS biopsy material reached an adequacy of 98.3% and was adequate for Ki-67 evaluation in 84.7% of cases. Twenty-nine patients (49.2%) underwent surgery. Of these, 25 patients had Ki-67 evaluated on EUS biopsy: the agreement between EUS biopsy grading and surgical specimen grading was 84%. Conclusion: EUS biopsy is an accurate method for the diagnosis and grading of pNETs based on the WHO 2017 Ki-67 labelling scheme.

Download Full-text