Two cases of resectable pancreatic cancer diagnosed by open surgical biopsy after endoscopic ultrasound fine-needle aspiration failed to yield diagnosis: case reports.
Two cases of resectable pancreatic cancer diagnosed by open surgical biopsy after endoscopic ultrasound fine-needle aspiration failed to yield diagnosis: case reports.
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DOI：
10.1186/s40792-017-0314-2
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发表时间：
2017-12
影响因子：
0.8
通讯作者：
Doki Y
中科院分区：
文献类型：
--
作者：
Toshiyama R;Noda T;Eguchi H;Iwagami Y;Yamada D;Asaoka T;Wada H;Kawamoto K;Gotoh K;Takeda Y;Tanemura M;Morii E;Umeshita K;Mori M;Doki Y
胰腺癌患者在术前和开始化疗或放疗前需要进行肿瘤活检以进行组织学诊断（胰腺癌：临床实践指南，欧洲医学肿瘤学会）。内镜超声细针抽吸（EUS-FNA）被广泛应用于获取组织样本进行组织学检查。然而，在某些情况下，EUS-FNA不能安全地进行或组织样本不足以建立明确的诊断。我们提出两例胰腺癌的诊断后，开放手术活检EUS-FNA未能产生诊断。例1为一50岁男性，电脑断层显示胰脏钩部有一少血供病灶。虽然EUS-FNA进行了两次，我们不能收集足够数量的组织样本，以建立一个明确的诊断。开放手术活检显示腺癌，患者接受术前放化疗治疗，随后进行根治性手术。例2为一68岁男性，电脑断层显示胰脏钩部有一少血供肿瘤。EUS显示一个14 mm的低回声病变，但我们无法进行EUS-FNA，因为上级肠系膜静脉位于穿刺线上。开放性手术活检显示腺癌，患者接受了术前放化疗治疗，随后进行了胰腺切除术。EUS-FNA是诊断胰腺肿瘤的首选方法，但EUS-FNA不成功时，开放手术活检是有效的诊断方法。
Tumor biopsy for histological diagnosis is required preoperatively and before initiating chemotherapy or radiation therapy for patients with pancreatic cancer (Cancer of the Pancreas: Clinical Practice Guidelines, European Society for Medical Oncology). Endoscopic ultrasound fine-needle aspiration (EUS-FNA) is widely applied to obtain tissue samples for histological examination. However, in some cases, EUS-FNA cannot be performed safely or tissue samples are insufficient to establish a definitive diagnosis. We present two cases of pancreatic cancer diagnosed by open surgical biopsy after EUS-FNA failed to yield a diagnosis. Case 1 was a 50-year-old man. Computed tomography showed a hypovascular lesion in the uncus of the pancreas. Although EUS-FNA was conducted twice, we could not collect enough quantity of tissue samples to establish a definitive diagnosis. Open surgical biopsy revealed adenocarcinoma, and the patient underwent preoperative chemoradiation therapy followed by curative operation. Case 2 was a 68-year-old man. Computed tomography showed a hypovascular tumor in the uncus of the pancreas. EUS revealed a 14-mm hypoechoic lesion, but we could not perform EUS-FNA because the superior mesenteric vein was located in the puncture line. Open surgical biopsy revealed adenocarcinoma, and the patient underwent preoperative chemoradiation therapy followed by pancreaticoduodenectomy. EUS-FNA is the first choice in the diagnostic modalities of pancreatic neoplasm, but open surgical biopsy is an effective diagnostic method if EUS-FNA is unsuccessful.