Endoskopisk ultralydskanning af patienter, hos hvem der er mistanke om neuroendokrine tumorer
Sammanfattning
Background: Endoscopic ultrasonography (EUS) is a valuable diagnostic tool for evaluating pathologies in or in relation to the upper gastrointestinal tract. The aim of this study was to evaluate the diagnostic yield of EUS in patients suspected of neuroendocrine tumours. Materials and methods: Retrospective analysis of data from the department's local EUS database and from hospital records. Results: From November 2001 to December 2006, 21 patients were referred for EUS due to suspected neuroendocrine tumour. 17 patients were females and 4 were males. The median age was 48 years (range 14-93 years). 13 patients had symptoms (hypoglycaemia) suggesting that an insulinoma could be present. The remaining 8 patients had different kinds of symptoms including patients whose tumour was found by chance by another imaging modality. In 8 patients, EUS did not show any pathology. At follow-up, 6 of these were without any symptoms. One patient had died and one patient had subsequent surgery for intestinal obstruction due to a neuroendocrine carcinoma in the ileum and liver metastases. EUS revealed a mass lesion in 13 patients. 7 of these have had a CT scan which showed normal findings in 4. External ultrasound had been performed in 8 of the 13 patients, and showed normal findings in 4 out of the 8. All 13 patients with mass lesions had subsequent surgery showing different kinds of neuroendocrine tumours in 11 patients, adenocarcinoma of the pancreas in one patient, and normal findings in one case. Conclusion: EUS may detect NETs which have not being visualised by other imaging modalities. EUS should be performed early in the diagnostic work up if a NET is suspected.