Clinical impact of endoscopic ultrasonography on the management of neuroendocrine tumors: lights and shadows |
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Institution: | 1. Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca’ Granda — Ospedale Maggiore Policlinico, Milan, Italy;2. Postgraduate School of Gastroenterology, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy;3. PancreatoBiliary Endoscopy and Endosonography Division, Pancreas Translatiinal and Clinical Research Center, San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milan, Italy |
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Abstract: | The incidence of gastroenteropancreatic neuroendocrine neoplasms has increased in the recent decades.An extensive bibliographical search was performed in PubMed to identify guidelines and primary literature (retrospective and prospective studies, systematic reviews, case series) published mostly between year 1997 and June 2017, using both medical subject heading (MeSH) terms and free-language keywords about the accuracy and diagnostic and therapeutic role of endoscopic ultrasound in the context of gastro-entero-pancreatic neuroendocrine neoplasms.Endoscopic ultrasound is the modality of choice for diagnosing pancreatic neuroendocrine neoplasms and for the locoregional staging of gastric, duodenal, pancreatic and rectal neuroendocrine neoplasms; in particular, in the setting of pancreatic neuroendocrine neoplasms it has demonstrated higher accuracy in tumor detection than other imaging modalities.Furthermore, the possibility of tattooing pancreatic lesions by endoscopic ultrasound fine needle aspiration may help surgeons to locate the tumor and avoid any demolition surgery. Finally, endoscopic ultrasound-guided therapies have been proposed and used in several studies for patients unsuitable for surgery, with good results on the control of symptoms and the reduction of tumor burden. |
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Keywords: | Endoscopic ultrasound Endoscopic ultrasound-guided fine-needle aspiration Neuroendocrine neoplasm |
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