Endoskopska ultrasonografija (EUS) u preoperativnoj lokalizaciji neuroendokrinih tumora (NET) pankreasa

Background: Preoperative localization of pancreatic neuroendocrine tumors (NET) is usually very difficult. Noninvasive, imaging tests, such as abdominal ultrasound, CT or MRI are not sensitive enough as well as selective angiography. The aim of the study was to clarify the usefulness of the EUS in preoperative localization of the pancreatic NET. Methods: From September 1998 - March 2005, EUS was performed in 1600 patients. Among them, in 10 (0,7%), this examination was carried out due to previous biochemical tests, which diagnosed the pancreatic NET. We studied the location, the size and echo-pattern of the neoplasm. The results were compared with operation and histology or EUS- FNA guided pancreatic biopsy in 9/10 patients. All EUS examinations were performed using Olympus GIF-130 videoecho-endoscope with 7,5 /12MHz switch able radial probe. Results: EUS correctly localized the pancreatic NET in 7/8 cases, (sensitivity:87,5%). In 2 patients, EUS accurately excluded pancreatic NET. There were no false positive findings (specificity 100%). Six tumors were benign (75%), and two were malign (25%). We localized 6 insulinomas and single pancreatic carcinoid tumor. The median tumor size detected by EUS was 21mm. Conclusion: EUS is highly accurate in preoperative localization of the pancreatic NET-s and We confirmed it in our study. EUS presents the method of choice for preoperative localization of the pancreatic NET.