BCM
Gastroenterology Grand Rounds - Take Home Lessons
The main lessons to take home concerning this case are:
1. The accuracy of EUS in staging of pancreatic adenocarcinoma
and assessment of vessel involvement may not be as high as earlier proposed.
2. Overstaging of lesions frequently occurs with vascular
overassessment and this may be decreased by restricting EUS criteria to
tumor within the lumen and or encasement/obstruction of vessel and less
reliance on criteria such as loss of hyperechoic vessel wall/tumor interface.
3. Understaging of lesions frequently occurs with tumors
greater than 3cm in size.
4. The role of EUS in pancreatic cancer appears to be in
identifying lesions not imaged by other means and in allowing FNA of lesions.
