Yane Kei, Aoki Mai, Tomita Yusuke, Yoshida Masahiro, Morita Kotaro, Ihara Hideyuki, Sumiyoshi Tetsuya, Kondo Hitoshi, Oyamada Yumiko
Department of Gastroenterology Tonan Hospital Hokkaido Japan.
Department of Pathology Tonan Hospital Hokkaido Japan.
DEN Open. 2022 May 9;3(1):e124. doi: 10.1002/deo2.124. eCollection 2023 Apr.
Reports of needle tract seeding (NTS) as a complication of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) have been increasing. To date, most of the reported cases of NTS have been diagnosed during the postoperative follow-up period. Herein, we report a case of NTS that occurred during preoperative neoadjuvant chemotherapy after EUS-FNA for resectable pancreatic cancer. The patient underwent transgastric EUS-FNA for a pancreatic tail tumor. He was diagnosed as having resectable pancreatic cancer and received preoperative neoadjuvant chemotherapy. After completion of the chemotherapy, computed tomography showed a thick-walled cyst-like structure appearing between the pancreas and the gastric wall. Combined resection revealed adenocarcinoma invasion into the cyst-like structure. Based on the clinical course, and surgical and pathological findings, the condition was diagnosed as NTS. It is thus crucial that after EUS-FNA, a detailed review of the imaging findings be conducted in the preoperative period. If adhesions between the stomach and the pancreas are observed after transgastric EUS-FNA, combined resection of the gastric wall should be considered.
作为内镜超声引导下细针穿刺抽吸术(EUS-FNA)并发症的针道种植(NTS)的报道日益增多。迄今为止,大多数报道的NTS病例是在术后随访期间确诊的。在此,我们报告1例在可切除胰腺癌的EUS-FNA术后新辅助化疗期间发生的NTS病例。该患者因胰尾肿瘤接受了经胃EUS-FNA。他被诊断为可切除的胰腺癌并接受了术前新辅助化疗。化疗结束后,计算机断层扫描显示胰腺和胃壁之间出现了一个厚壁囊肿样结构。联合切除显示腺癌侵犯到囊肿样结构。根据临床病程以及手术和病理结果,该病情被诊断为NTS。因此,在EUS-FNA术后,在术前阶段对影像学检查结果进行详细复查至关重要。如果在经胃EUS-FNA后观察到胃和胰腺之间有粘连,则应考虑联合切除胃壁。
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