Endoscopy 2021; 53(S 01): S222-S223
DOI: 10.1055/s-0041-1724878
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Contrast-Enhanced Endoscopic Ultrasound in the Diagnosis of Pancreatic Metastasis

C Teodorescu
1   Iuliu Hațieganu University of Medicine and Pharmacy, Department of Gastroenterology, Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
,
C Pojoga
1   Iuliu Hațieganu University of Medicine and Pharmacy, Department of Gastroenterology, Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
2   Babeș-Bolyai University, Department of Clinical Psychology and Psychotherapy, International Institute for Advanced Study of Psychotherapy and Applied Mental Health, Cluj-Napoca, Romania
,
I Rusu
3   Iuliu Hațieganu University of Medicine and Pharmacy, Department of Pathology, Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
,
SD Bolboacă
4   Iuliu Hațieganu University of Medicine and Pharmacy, Department of Medical Informatics and Biostatistics, Cluj-Napoca, Romania
,
A Seicean
1   Iuliu Hațieganu University of Medicine and Pharmacy, Department of Gastroenterology, Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
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    Aims Less than 5 % of the pancreatic tumors represent a metastasis. It is still difficult to distinguish pancreatic metastasis from a primary pancreatic tumor only by echoendoscopic (EUS) appearance. The vascularity pattern assessed during the contrast-enhanced endoscopic ultrasound (CEUS) has been rarely described.

    Aim To assess the additional role of CEUS over EUS morphology in diagnosing pancreatic metastases.

    Methods We retrospectively included the patients with a diagnosis of pancreatic metastasis based on documented oncologic disease, EUS morphology with or without CEUS, in a tertiary medical center between 1st of January 2012 and 31st of October 2020. The final diagnosis was based on EUS-FNA and histopathologic results.

    Results There were included 24 patients with hypoechoic masses, most of them localized in the pancreatic head (n = 10; 39 %). The origin of malignancy was lung and kidney (7 cases each), followed by colon, skin, and sarcoma (2 patients each), and breast, stomach, ovary, and liver (1 patient each). CEUS was done in 62 % of cases (n = 15), and the arterial hyperenhancement with rapid washout was noticed in 10 of these tumors, originating from kidney (n = 5), lung (n = 3), liver (n = 1) or skin (n = 1). This did not add information over the Doppler assessment, although for the renal metastases the initial peripheral hyperenhancement was noted in four of the cases. The other five patients with homogenous arterial hypoenhancement at CEUS, originating from colon, breast, or ovary, but also the lung and the skin, had no particular pattern in helping their discrimination from pancreatic adenocarcinoma.

    Conclusions EUS brings an important contribution to diagnosing pancreatic metastasis, with heterogeneous characteristics that can not differentiate their origin. The CEUS aspect of metastasis is also heterogeneous and without specific features for lesions with the same origin. EUS-FNA remains compulsory for obtaining the diagnosis, while CEUS does not add supplemental value to EUS morphology assessment.

    Citation Teodorescu C, Pojoga C, Rusu I et al. eP387 CONTRAST-ENHANCED ENDOSCOPIC ULTRASOUND IN THE DIAGNOSIS OF PANCREATIC METASTASIS. Endoscopy 2021; 53: S222.


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    Publication History

    Article published online:
    19 March 2021

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