Diagnostic and Interventional Role of Endoscopic Ultrasonography for the Management of Pancreatic Neuroendocrine Neoplasms
Pancreatic neuroendocrine neoplasms (PanNENs) are relatively rare, but their incidence has increased significantly in the last decades. Precise diagnosis and prognostic stratification are crucial for proper patient management. Endoscopic ultrasound (EUS) is the modality of choice for diagnosis of so...
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doaj-05832c7ee9ff479a98aac73a03be06da2021-07-01T00:15:43ZengMDPI AGJournal of Clinical Medicine2077-03832021-06-01102638263810.3390/jcm10122638Diagnostic and Interventional Role of Endoscopic Ultrasonography for the Management of Pancreatic Neuroendocrine NeoplasmsGiuseppinella Melita0Socrate Pallio1Andrea Tortora2Stefano Francesco Crinò3Antonio Macrì4Gianlorenzo Dionigi5Department of Human Pathology of Adult and Pediatric Age, University of Messina, 98100 Messina, ItalyDepartment of Internal Medicine and Medical Therapy, University of Messina, 98100 Messina, ItalyDigestive Endoscopy Unit, Azienda Ospedaliera Universitaria Policlinico, G. Martino, 98100 Messina, ItalyGastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, 37134 Verona, ItalyDepartment of Human Pathology of Adult and Pediatric Age, University of Messina, 98100 Messina, ItalyDepartment of Human Pathology of Adult and Pediatric Age, University of Messina, 98100 Messina, ItalyPancreatic neuroendocrine neoplasms (PanNENs) are relatively rare, but their incidence has increased significantly in the last decades. Precise diagnosis and prognostic stratification are crucial for proper patient management. Endoscopic ultrasound (EUS) is the modality of choice for diagnosis of solid pancreatic tumors, showing a higher tumor detection rate than other imaging modalities, especially for small size lesions. EUS also serves as a guide for preoperative sampling and other interventions. EUS-tissue acquisition is a safe and highly accurate technique for cyto/histological diagnosis of PanNENs with a well-demonstrated correlation between Ki-67 proliferation index values and tumor grading on EUS and surgical specimens according to the WHO 2017 classification. Furthermore, the possibility of a preoperative EUS-guided fine needle tattooing or fiducial markers placement may help the surgeon to locate small and deep tumors, thus avoiding formal pancreatic resections in favor of parenchymal-sparing surgery. Finally, locoregional ablative treatments using either ethanol injection or radiofrequency ablation have been proposed in recent studies with promising results in order to control symptoms or reduce tumor burden in selected patients unfit for surgery with functioning or non-functioning PanNENs. This article review highlights the current role of EUS in PanNENs management, focusing on the present and future applications of EUS-guided interventions.https://www.mdpi.com/2077-0383/10/12/2638pancreatic neuroendocrine neoplasms (PanNENs)endoscopic ultrasonography (EUS)endoscopic ultrasound-guided fine needle aspiration (EUS-FNA)endoscopic ultrasound-guided fiducial placementendoscopic ultrasound guided tattooingethanol ablation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Giuseppinella Melita Socrate Pallio Andrea Tortora Stefano Francesco Crinò Antonio Macrì Gianlorenzo Dionigi |
spellingShingle |
Giuseppinella Melita Socrate Pallio Andrea Tortora Stefano Francesco Crinò Antonio Macrì Gianlorenzo Dionigi Diagnostic and Interventional Role of Endoscopic Ultrasonography for the Management of Pancreatic Neuroendocrine Neoplasms Journal of Clinical Medicine pancreatic neuroendocrine neoplasms (PanNENs) endoscopic ultrasonography (EUS) endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) endoscopic ultrasound-guided fiducial placement endoscopic ultrasound guided tattooing ethanol ablation |
author_facet |
Giuseppinella Melita Socrate Pallio Andrea Tortora Stefano Francesco Crinò Antonio Macrì Gianlorenzo Dionigi |
author_sort |
Giuseppinella Melita |
title |
Diagnostic and Interventional Role of Endoscopic Ultrasonography for the Management of Pancreatic Neuroendocrine Neoplasms |
title_short |
Diagnostic and Interventional Role of Endoscopic Ultrasonography for the Management of Pancreatic Neuroendocrine Neoplasms |
title_full |
Diagnostic and Interventional Role of Endoscopic Ultrasonography for the Management of Pancreatic Neuroendocrine Neoplasms |
title_fullStr |
Diagnostic and Interventional Role of Endoscopic Ultrasonography for the Management of Pancreatic Neuroendocrine Neoplasms |
title_full_unstemmed |
Diagnostic and Interventional Role of Endoscopic Ultrasonography for the Management of Pancreatic Neuroendocrine Neoplasms |
title_sort |
diagnostic and interventional role of endoscopic ultrasonography for the management of pancreatic neuroendocrine neoplasms |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-06-01 |
description |
Pancreatic neuroendocrine neoplasms (PanNENs) are relatively rare, but their incidence has increased significantly in the last decades. Precise diagnosis and prognostic stratification are crucial for proper patient management. Endoscopic ultrasound (EUS) is the modality of choice for diagnosis of solid pancreatic tumors, showing a higher tumor detection rate than other imaging modalities, especially for small size lesions. EUS also serves as a guide for preoperative sampling and other interventions. EUS-tissue acquisition is a safe and highly accurate technique for cyto/histological diagnosis of PanNENs with a well-demonstrated correlation between Ki-67 proliferation index values and tumor grading on EUS and surgical specimens according to the WHO 2017 classification. Furthermore, the possibility of a preoperative EUS-guided fine needle tattooing or fiducial markers placement may help the surgeon to locate small and deep tumors, thus avoiding formal pancreatic resections in favor of parenchymal-sparing surgery. Finally, locoregional ablative treatments using either ethanol injection or radiofrequency ablation have been proposed in recent studies with promising results in order to control symptoms or reduce tumor burden in selected patients unfit for surgery with functioning or non-functioning PanNENs. This article review highlights the current role of EUS in PanNENs management, focusing on the present and future applications of EUS-guided interventions. |
topic |
pancreatic neuroendocrine neoplasms (PanNENs) endoscopic ultrasonography (EUS) endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) endoscopic ultrasound-guided fiducial placement endoscopic ultrasound guided tattooing ethanol ablation |
url |
https://www.mdpi.com/2077-0383/10/12/2638 |
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