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Endoscopic ultrasonography for evaluation of pancreatic tumours in multiple endocrine neoplasia type 1.

Hellman P, Hennings J, Akerström G, Skogseid B

Department of Surgery, University Hospital, SE-751 85 Uppsala, Sweden. per.hellman@surgsci.uu.se

BACKGROUND: Pancreatic tumours are common in patients with multiple endocrine neoplasia type 1 (MEN1), and close surveillance is needed to detect pancreatic lesions at an early stage. Conventional radiology is inefficient in verifying the small tumours indicated by biochemical screening. During the past decade, endoscopic ultrasonography (EUS) has evolved as a sensitive method for the detection of small pancreatic lesions. METHODS: EUS was evaluated in 25 patients with MEN1, two of whom had symptoms due to hormonal secretion. Twenty-two patients had biochemical signs of pancreatic tumours, and in five patients lesions were located by either computed tomography (two) or transabdominal ultrasonography (three). RESULTS: EUS visualized pancreatic tumours in the five patients in whom lesions were detected by the other methods and in a further nine patients. Eight of these 14 patients had surgery, and tumours were confirmed histopathologically. No lesion was detected in any of the 11 patients with no tumour detected by EUS. CONCLUSION: EUS is a more sensitive technique for the detection and localization of potentially malignant lesions in patients with MEN1 than computed tomography or transabdominal ultrasonography.

Published 1 December 2005 in Br J Surg, 92(12): 1508-12.
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