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Endoscopy 2008; 40(3): 200-203
DOI: 10.1055/s-2007-995364
Original article

© Georg Thieme Verlag KG Stuttgart · New York

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

N.  Jani1 , J.  Dewitt2 , M.  Eloubeidi3 , S.  Varadarajulu3 , V.  Appalaneni4 , B.  Hoffman4 , W.  Brugge5 , K.  Lee1 , A.  Khalid1 , K.  McGrath1
  • 1University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
  • 2Indiana University Medical Center, Indianapolis, Indiana, USA
  • 3University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
  • 4Medical University of South Carolina, Charleston, South Carolina, USA
  • 5Massachusetts General Hospital, Boston, Massachusetts, USA
Further Information

Publication History

submitted 12 June 2007

accepted after revision 24 October 2007

Publication Date:
07 December 2007 (online)

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Commentaire de travail de N. Jani et al., pp. 200Endoscopy 2008; 40(03): 356-356
DOI: 10.1055/s-0032-1306815

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 ultrasound 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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K. McGrath, MD

UPMC Presbyterian

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Fax: +1-412-383-8992

Email: mcgrathk@dom.pitt.edu

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