Endoscopy 2021; 53(S 01): S72
DOI: 10.1055/s-0041-1724433
Abstracts | ESGE Days
ESGE Days 2021 Oral presentations
Saturday, 27 March 2021 10:00 – 10:45 Can we still improve EUS diagnostic accuracy? Room 6

Hypervascular Pancreatic Lesions on Contrast-Enhanced EUS: Beyond Neuroendocrine Tumors

IM Cazacu
1   Research Center of Gastroenterology an Hepatology, University of Medicine and Pharmacy Craiova, Craiova, Romania
2   Fundeni Clinical Institute, Bucharest, Romania
,
IF Cherciu Harbiyeli
1   Research Center of Gastroenterology an Hepatology, University of Medicine and Pharmacy Craiova, Craiova, Romania
,
A Constantin
3   Ponderas Academic Hospital, Bucharest, Romania
,
C Copaescu
3   Ponderas Academic Hospital, Bucharest, Romania
,
V Tomulescu
3   Ponderas Academic Hospital, Bucharest, Romania
,
N Bejinariu
4   Santomar Onco Diagnostic, Cluj-Napoca, Romania
,
V Surlin
5   Department of Surgery, University of Medicine and Pharmacy of Craiova, Craiova, Romania
,
C Stroescu
6   Center of General Surgery and Transplant, “Sf. Maria” Clinical Hospital, Bucharest, Romania
,
C Popescu
1   Research Center of Gastroenterology an Hepatology, University of Medicine and Pharmacy Craiova, Craiova, Romania
,
A Saftoiu
1   Research Center of Gastroenterology an Hepatology, University of Medicine and Pharmacy Craiova, Craiova, Romania
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    Aims Although pancreatic neuroendocrine tumors (PNETs) typically have a solid, hypervascular appearance on contrast-enhanced endoscopic ultrasound (CE-EUS), other non-PNET lesions may have a similar appearance. It is important to discriminate hypervascular pancreatic lesions because of different treatment option and prognosis. With this background, we decided to review our single-center experience with regard to hypervascular pancreatic lesions on CE-EUS.

    Methods Patients from our institutional database who underwent EUS evaluation of a pancreatic lesion and had a hyperenhanced appearance on CE-EUS were retrieved. Microvascularization of the tumor was evaluated over 2 min during CE-EUS after intravenous injection of 4.8 mL SonoVue. Final diagnosis was based on histopathology of surgical specimens or EUS-guided tissue acquisition and clinical follow-up.

    Results Between 2007 and 2020, 77 patients with hypervascular pancreatic lesions on CE-EUS were identified. Final pathology revealed PNET in 34 (44 %) and a non-PNET diagnosis in 43 (66 %). Of patients with a diagnosis of PNET, the lesion on EUS was solid in 31 (91 %) and cystic in 3 (9 %). Hypervascular solid lesions were also identified in 43 non-PNET patients with a final diagnosis of focal pancreatitis (25), solid pseudopapillary tumor (5), pancreatic metastases (6), pancreatic ductal adenocarcinoma (3), acinar cell carcinoma (1) and lymphoma (3). There were no significant differences in age, gender, tumor size, tumor location, pancreatic or biliary duct dilation, or contrast enhancement patterns (homogenous vs heterogeneous) between patients with PNET vs non-PNET diagnoses. All patients with hypervascular pancreatic lesions have undergone EUS-FNA/FNB with an overall diagnostic accuracy of 90 %.

    Conclusions Several other benign and malignant non-PNET diagnoses may have a hypervascular appearance on CE-EUS. EUS-FNA and additional diagnostic modalities should be routinely performed to confirm a diagnosis prior any therapeutic decision.

    Citation: Cazacu IM, Cherciu Harbiyeli IF, Constantin A et al. OP176 HYPERVASCULAR PANCREATIC LESIONS ON CONTRAST-ENHANCED EUS: BEYOND NEUROENDOCRINE TUMORS. Endoscopy 2021; 53: S72.


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    Publication History

    Article published online:
    19 March 2021

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