EUS changes diagnosis from pancreatic to gallbladder carcinoma.

A patient was referred for endoscopic ultrasound (EUS) for preoperative staging of what was believed to be pancreatic cancer, based on minimal findings on computed tomography (CT) and highly elevated CA19-9. EUS imaged a normal pancreas, but a tumor mass was identified in the gallbladder, and proven to be adenocarcinoma using EUS-guided fine-needle aspiration (FNA). Open cholecystectomy was curative. CA19-9 is not a highly specific marker. EUS is emerging as a highly sensitive and specific test for pancreatic cancer. EUS can complement other imaging modalities, and reveal unsuspected pathologies, such as in the patient described in this report, with major clinical impact.