EUS GUIDED FINE NEEDLE ASPIRATION OF RENAL AND ADRENAL LESIONS. SINGLE CENTER RESTROSPECTIVE ANALYSIS

Aims To describe the technique, adverse events and results of EUS-guided renal and adrenal fine needle aspiration (FNA) of radiologically indeterminate lesions.

Tab.1 Diagnostics

N=36	Renal lesions (n=8)	Adrenal lesions (n=28)
Metastasis - Lung cancer - Pancreatic adenocarcinoma - Urinary bladder carcinoma - Unknow primary	0 0 0 1 (12.5%)	16 (57.1%) 1 (3.6%) 1 (3.6%) 6 (21.4%)
Renal neoplasia	4 (50%)	1 (3,6%)
Benign	3 (37,5%)	3 (10,7%)

Methods Retrospective case series of a prospective database including echoendoscopies from March 2014 to August 2018. Diagnosis, adverse events, and follow-up data were retrospectively collected. A biopsy was considered successful if it allowed a histological diagnosis. Malignant required confirmation in surgical specimens if available, although in non-surgical patients the cytological diagnosis was assumed; benign diagnoses required radiological stability during ≥12 months.

Results We identified 36 patients with a mean age of 67 (SD: 10) years; 27 (75%) men. Eight (22.2%) were renal biopsies (5 right, 3 left) and 28 (77.8%) adrenal biopsies (4 (14.3%) right, 21 (75%) left, and 3 (10.7%) bilateral). 100% of the biopsies were diagnostic, without adverse events. Average size of the masses was 33 mm (ICR 25-47). The predominant endosonographic pattern was solid (97%) and hypoechogenic (69%). The majority of FNAs were performed through a transgastric access (77%) with 22G cytology needles (97,2% cases) with 3 and 4 needle passes in 83% of cases. Larger size (p = 0.05) and solid, hypoechogenic endosonographic pattern (p = 0.08) showed a tendency to be associated with a malignant etiology.

Conclusions EUS-guided FNA is an effective and safe tool in the diagnosis of renal/adrenal masses of uncertain origin.