A Multidisciplinary survey on controversies in the use of EUS-guided FNA: assessing perspectives of surgeons, oncologists and gastroenterologists

<p>Abstract</p> <p>Background</p> <p>EUS-guided FNA can help diagnose and differentiate between various pancreatic and other lesions.</p> <p>The aim of this study was to compare approaches among involved/relevant physicians to the controversies surrounding the use of FNA in EUS.</p> <p>Methods</p> <p>A five-case survey was developed, piloted, and validated. It was collected from a total of 101 physicians, who were all either gastroenterologists (GIs), surgeons or oncologists. The survey compared the management strategies chosen by members of these relevant disciplines regarding EUS-guided FNA.</p> <p>Results</p> <p>For CT operable T2NOM0 pancreatic tumors the research demonstrated variance as to whether to undertake EUS-guided FNA, at p < 0.05. For inoperable pancreatic tumors 66.7% of oncologists, 62.2% of surgeons and 79.1% of GIs opted for FNA (p < 0.05). For cystic pancreatic lesions, oncologists were more likely to send patients to surgery without FNA. For stable simple pancreatic cysts (23 mm), most physicians (66.67%) did not recommend FNA. For a submucosal gastric 19 mm lesion, 63.2% of surgeons recommended FNA, vs. 90.0% of oncologists (p < 0.05).</p> <p>Conclusions</p> <p>Controversies as to ideal application of EUS-FNA persist. Optimal guidelines should reflect the needs and concerns of the multidisciplinary team who treat patients who need EUS-FNA. Multi-specialty meetings assembled to manage patients with these disorders may be enlightening and may help develop consensus.</p

EUS-FNA for a Pancreatic Neuroendocrine Tumor in a Four-Year-Old Daughter of a Woman Exposed to Radiation at Chernobyl

Pancreatic neoplasms in children are rare. Herein is reported the case of a four-year-old girl whose mother was exposed to radiation at Chernobyl that presented with obstructive jaundice and a mass suspected on CT and diagnosed by endoscopic ultrasound (EUS) with fine needle aspiration (FNA). This child is probably the youngest case of application of linear EUS with biopsy to be described. The diagnosis, management, and followup of children with this rare tumor are discussed