Endoscopic ultrasound-guided fine-needle aspiration for diagnosis of solid pseudopapillary tumors of the pancreas: A multicenter experience

N. Jani, John DeWitt, M. Eloubeidi, S. Varadarajulu, V. Appalaneni, B. Hoffman, W. Brugge, K. Lee, A. Khalid, K. McGrath

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Abstract

Background and study aims: Solid pseudopapillary tumors of the pancreas are rare, low-grade, epithelial neoplasms that are usually discovered incidentally in young women. Distinguishing solid pseudopapillary tumors from other pancreatic tumors, especially pancreatic endocrine tumors, can be challenging. The role of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in this context remains unclear. The purpose of this study was to describe the endoscopic ultra-sound features of solid pseudopapillary tumors and the role of EUS-FNA in the preoperative diagnosis of these tumors. Patients and methods: Patients from five tertiary referral centers with surgically confirmed solid pseudopapillary tumors who had undergone preoperative EUS-FNA were included. The endoscopic ultrasound findings, cytologic descriptions, immunostaining results, operative records, surgical pathology, and results of the most recent clinical follow-up were reviewed. Results: A total of 28 patients were identified (four men [14%], 24 women [86%], mean age ± standard deviation [SD] 35±10 years). Solid pseudopapillary tumors had been found as incidental findings on cross-sectional imaging in 50% of cases. The mean tumor size±SD was 42 ± 19.5 mm and the majority were located in the pancreatic body and tail. The endoscopic ultrasound report described a well-defined, echo-poor mass in 86%; the tumors were solid in 14 patients (50%), mixed solid and cystic in 11 patients (39 %), and cystic in three patients (11 %). A preoperative diagnosis of solid pseudopapillary tumor was made in 21 patients (75 %) on the basis of EUS-FNA cytology. Surgical resection was performed in all cases. Laparoscopic resection was performed in eight of these patients (29 %). Conclusions: A solid pseudopapillary tumor should be included in the differential diagnosis of any well-demarcated, echo-poor, solid or mixed solid/cystic pancreatic lesion seen during endoscopic ultrasound, particularly in young women. The diagnostic accuracy of EUS-FNA for solid pseudopapillary tumors was 75% in this study. A definitive preoperative diagnosis can guide the surgical approach in selected cases.

Original languageEnglish
Pages (from-to)200-203
Number of pages4
JournalEndoscopy
Volume40
Issue number3
DOIs
StatePublished - Mar 2008

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Endoscopic Ultrasound-Guided Fine Needle Aspiration
Pancreas
Neoplasms
Surgical Pathology
Incidental Findings
Glandular and Epithelial Neoplasms
Tertiary Care Centers

ASJC Scopus subject areas

  • Medicine (miscellaneous)

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Endoscopic ultrasound-guided fine-needle aspiration for diagnosis of solid pseudopapillary tumors of the pancreas : A multicenter experience. / Jani, N.; DeWitt, John; Eloubeidi, M.; Varadarajulu, S.; Appalaneni, V.; Hoffman, B.; Brugge, W.; Lee, K.; Khalid, A.; McGrath, K.

In: Endoscopy, Vol. 40, No. 3, 03.2008, p. 200-203.

Research output: Contribution to journalArticle

Jani, N, DeWitt, J, Eloubeidi, M, Varadarajulu, S, Appalaneni, V, Hoffman, B, Brugge, W, Lee, K, Khalid, A & McGrath, K 2008, 'Endoscopic ultrasound-guided fine-needle aspiration for diagnosis of solid pseudopapillary tumors of the pancreas: A multicenter experience', Endoscopy, vol. 40, no. 3, pp. 200-203. https://doi.org/10.1055/s-2007-995364
Jani, N. ; DeWitt, John ; Eloubeidi, M. ; Varadarajulu, S. ; Appalaneni, V. ; Hoffman, B. ; Brugge, W. ; Lee, K. ; Khalid, A. ; McGrath, K. / Endoscopic ultrasound-guided fine-needle aspiration for diagnosis of solid pseudopapillary tumors of the pancreas : A multicenter experience. In: Endoscopy. 2008 ; Vol. 40, No. 3. pp. 200-203.
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abstract = "Background and study aims: Solid pseudopapillary tumors of the pancreas are rare, low-grade, epithelial neoplasms that are usually discovered incidentally in young women. Distinguishing solid pseudopapillary tumors from other pancreatic tumors, especially pancreatic endocrine tumors, can be challenging. The role of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in this context remains unclear. The purpose of this study was to describe the endoscopic ultra-sound features of solid pseudopapillary tumors and the role of EUS-FNA in the preoperative diagnosis of these tumors. Patients and methods: Patients from five tertiary referral centers with surgically confirmed solid pseudopapillary tumors who had undergone preoperative EUS-FNA were included. The endoscopic ultrasound findings, cytologic descriptions, immunostaining results, operative records, surgical pathology, and results of the most recent clinical follow-up were reviewed. Results: A total of 28 patients were identified (four men [14{\%}], 24 women [86{\%}], mean age ± standard deviation [SD] 35±10 years). Solid pseudopapillary tumors had been found as incidental findings on cross-sectional imaging in 50{\%} of cases. The mean tumor size±SD was 42 ± 19.5 mm and the majority were located in the pancreatic body and tail. The endoscopic ultrasound report described a well-defined, echo-poor mass in 86{\%}; the tumors were solid in 14 patients (50{\%}), mixed solid and cystic in 11 patients (39 {\%}), and cystic in three patients (11 {\%}). A preoperative diagnosis of solid pseudopapillary tumor was made in 21 patients (75 {\%}) on the basis of EUS-FNA cytology. Surgical resection was performed in all cases. Laparoscopic resection was performed in eight of these patients (29 {\%}). Conclusions: A solid pseudopapillary tumor should be included in the differential diagnosis of any well-demarcated, echo-poor, solid or mixed solid/cystic pancreatic lesion seen during endoscopic ultrasound, particularly in young women. The diagnostic accuracy of EUS-FNA for solid pseudopapillary tumors was 75{\%} in this study. A definitive preoperative diagnosis can guide the surgical approach in selected cases.",
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T1 - Endoscopic ultrasound-guided fine-needle aspiration for diagnosis of solid pseudopapillary tumors of the pancreas

T2 - A multicenter experience

AU - Jani, N.

AU - DeWitt, John

AU - Eloubeidi, M.

AU - Varadarajulu, S.

AU - Appalaneni, V.

AU - Hoffman, B.

AU - Brugge, W.

AU - Lee, K.

AU - Khalid, A.

AU - McGrath, K.

PY - 2008/3

Y1 - 2008/3

N2 - Background and study aims: Solid pseudopapillary tumors of the pancreas are rare, low-grade, epithelial neoplasms that are usually discovered incidentally in young women. Distinguishing solid pseudopapillary tumors from other pancreatic tumors, especially pancreatic endocrine tumors, can be challenging. The role of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in this context remains unclear. The purpose of this study was to describe the endoscopic ultra-sound features of solid pseudopapillary tumors and the role of EUS-FNA in the preoperative diagnosis of these tumors. Patients and methods: Patients from five tertiary referral centers with surgically confirmed solid pseudopapillary tumors who had undergone preoperative EUS-FNA were included. The endoscopic ultrasound findings, cytologic descriptions, immunostaining results, operative records, surgical pathology, and results of the most recent clinical follow-up were reviewed. Results: A total of 28 patients were identified (four men [14%], 24 women [86%], mean age ± standard deviation [SD] 35±10 years). Solid pseudopapillary tumors had been found as incidental findings on cross-sectional imaging in 50% of cases. The mean tumor size±SD was 42 ± 19.5 mm and the majority were located in the pancreatic body and tail. The endoscopic ultrasound report described a well-defined, echo-poor mass in 86%; the tumors were solid in 14 patients (50%), mixed solid and cystic in 11 patients (39 %), and cystic in three patients (11 %). A preoperative diagnosis of solid pseudopapillary tumor was made in 21 patients (75 %) on the basis of EUS-FNA cytology. Surgical resection was performed in all cases. Laparoscopic resection was performed in eight of these patients (29 %). Conclusions: A solid pseudopapillary tumor should be included in the differential diagnosis of any well-demarcated, echo-poor, solid or mixed solid/cystic pancreatic lesion seen during endoscopic ultrasound, particularly in young women. The diagnostic accuracy of EUS-FNA for solid pseudopapillary tumors was 75% in this study. A definitive preoperative diagnosis can guide the surgical approach in selected cases.

AB - Background and study aims: Solid pseudopapillary tumors of the pancreas are rare, low-grade, epithelial neoplasms that are usually discovered incidentally in young women. Distinguishing solid pseudopapillary tumors from other pancreatic tumors, especially pancreatic endocrine tumors, can be challenging. The role of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in this context remains unclear. The purpose of this study was to describe the endoscopic ultra-sound features of solid pseudopapillary tumors and the role of EUS-FNA in the preoperative diagnosis of these tumors. Patients and methods: Patients from five tertiary referral centers with surgically confirmed solid pseudopapillary tumors who had undergone preoperative EUS-FNA were included. The endoscopic ultrasound findings, cytologic descriptions, immunostaining results, operative records, surgical pathology, and results of the most recent clinical follow-up were reviewed. Results: A total of 28 patients were identified (four men [14%], 24 women [86%], mean age ± standard deviation [SD] 35±10 years). Solid pseudopapillary tumors had been found as incidental findings on cross-sectional imaging in 50% of cases. The mean tumor size±SD was 42 ± 19.5 mm and the majority were located in the pancreatic body and tail. The endoscopic ultrasound report described a well-defined, echo-poor mass in 86%; the tumors were solid in 14 patients (50%), mixed solid and cystic in 11 patients (39 %), and cystic in three patients (11 %). A preoperative diagnosis of solid pseudopapillary tumor was made in 21 patients (75 %) on the basis of EUS-FNA cytology. Surgical resection was performed in all cases. Laparoscopic resection was performed in eight of these patients (29 %). Conclusions: A solid pseudopapillary tumor should be included in the differential diagnosis of any well-demarcated, echo-poor, solid or mixed solid/cystic pancreatic lesion seen during endoscopic ultrasound, particularly in young women. The diagnostic accuracy of EUS-FNA for solid pseudopapillary tumors was 75% in this study. A definitive preoperative diagnosis can guide the surgical approach in selected cases.

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