BACKGROUND: The prognosis for patients with renal cell carcinoma metastatic to the pancreas is better than that for patients with primary pancreatic adenocarcinoma. In patients with a history of renal cell cancer, it would, therefore, appear necessary to obtain cytologic or histopathologic evidence of the tumor type. EUS-guided FNA is considered the technique of choice for this purpose. This study retrospectively assessed the efficacy of EUS-guided FNA and specific technical considerations when the procedure is performed for this indication. METHODS: Over 2 years, EUS-guided FNA was performed in 11 consecutive patients with a history of renal cell carcinoma and a solid mass within the pancreas. OBSERVATIONS: After EUS-guided FNA yielded a negative result in two patients, the sampling technique was modified, namely short aspiration with low negative vacuum pressure. This resulted in the detection of metastases of renal cell cancer in the remaining 9 patients. There was no procedure-related complication. CONCLUSIONS: EUS-guided FNA is safe and accurate for the diagnosis of pancreatic metastases of renal cell carcinoma. However, effective sampling requires techniques that differ from those used for solid pancreatic masses.
BACKGROUND: The prognosis for patients with renal cell carcinoma metastatic to the pancreas is better than that for patients with primary pancreatic adenocarcinoma. In patients with a history of renal cell cancer, it would, therefore, appear necessary to obtain cytologic or histopathologic evidence of the tumor type. EUS-guided FNA is considered the technique of choice for this purpose. This study retrospectively assessed the efficacy of EUS-guided FNA and specific technical considerations when the procedure is performed for this indication. METHODS: Over 2 years, EUS-guided FNA was performed in 11 consecutive patients with a history of renal cell carcinoma and a solid mass within the pancreas. OBSERVATIONS: After EUS-guided FNA yielded a negative result in two patients, the sampling technique was modified, namely short aspiration with low negative vacuum pressure. This resulted in the detection of metastases of renal cell cancer in the remaining 9 patients. There was no procedure-related complication. CONCLUSIONS: EUS-guided FNA is safe and accurate for the diagnosis of pancreatic metastases of renal cell carcinoma. However, effective sampling requires techniques that differ from those used for solid pancreatic masses.
Authors: José Celso Ardengh; César Vivian Lopes; Rafael Kemp; Filadélfio Venco; Eder Rios de Lima-Filho; José Sebastião dos Santos Journal: BMC Gastroenterol Date: 2013-04-11 Impact factor: 3.067