EUS-guided fine needle tattooing (EUS-FNT) for preoperative localization of small pancreatic neuroendocrine tumors (p-NETs): a single-center experience

Fausto Rosa, Mihai Rimbaș, Gianenrico Rizzatti, Giuseppe Quero, Claudio Fiorillo, Michele Impagnatiello, Francesca D’Aversa, Guido Costamagna, Sergio Alfieri, Alberto Larghi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: and study aims Pancreatic neuroendocrine tumors (pNETs) can be difficult to detect intra-operatively. The aim of this paper is to evaluate the safety and efficacy of preoperative endoscopic ultrasound guided fine needle tattooing (EUS-FNT) to facilitate intra-operative detection of pNETs. Patients and methods: Sixteen patients with pNETs (8 insulinoma and 8 non-functional pancreatic neuroendocrine tumors) underwent EUS-FNT. The procedure was carried out using the conventional curvilinear EUS. Tattooing was performed by intralesional injection of 1–2 mL of Spot® ink (Spot®, GI Supply, Comp Hill, PA, US) using a standard 22 gauge EUS-FNA needle. Results: All identified pNETs could be tattooed in one session. The procedure was well tolerated in all patients without any complication. The time interval between tattooing and surgery was between 1 and 565 days (mean of 52 days). Nine patients underwent open and seven laparoscopic surgery. The tattooed lesions could be recognized in all but one patient. In one patient, a small hematoma secondary to the EUS-FNT was observed. Pathological examination of the resection specimen showed local R0 resection in all cases, and no interference with the specimen evaluation was encountered. Conclusions: Our results suggest that EUS-guided FNT is a safe and useful method to mark preoperatively small (≤ 2 cm) pNETs.

Original languageEnglish
Pages (from-to)486-492
Number of pages7
JournalSurgical Endoscopy
Volume35
Issue number1
DOIs
Publication statusPublished - Jan 2021

Keywords

  • Endoscopic ultrasound
  • EUS
  • Pancreatic neuroendocrine tumors
  • pNET
  • Tattoo

ASJC Scopus subject areas

  • Surgery

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