EUS-guided fine needle tissue acquisition for the diagnosis of pleural metastases from endometrial cancer

A. Larghi, F. Lococo, S. Mainenti, G. Petrone, A. Cesario, P. Granone, G. Scambia, G. Costamagna

Research output: Contribution to journalArticlepeer-review


Transesophageal EUS-FNA have become a useful tool in the evaluation of the mediastinum, especially during the staging work-up examination of patients with non-small-cell lung cancer (NSCLC) or other malignancies. We report a challenging case of a 53 years-old woman with an endometrial adenocarcinoma who subsequently presented with right pleural effusion, diffuse pleural thickening with few pleural lesions. The patient referred a long history of exposure to amiantum, this posing a differential diagnosis between primary pleural tumour (mesothelioma) and neoplastic pleural localization of the endometrial cancer. The cytological examination of the pleural effusion (sampled via thoracenthesis) was not adequate to reach a diagnosis. Although a right-video-assisted thoracoscopy was considered the gold standard in this clinical setting to achieve a tissue acquisition of the pleura, an EUS (as the least invasive procedure) was attempted to reach a definitive diagnosis. EUS-FNTA of the pleura was done using a 19-Gauge needle and the pathological and immunophenotypic features were diagnostic for a pleural metastasis of high-grade endometrial serous carcinoma. The patient received adjuvant chemotherapy with a complete regression of the pleural lesions. We take the opportunity of this challenging case to discuss the efficacy and safety of EUS-FNAT to sample the pleural lesions with the use of a large calibre needle if the lesion lies just under the EUS cursor. We may assume that, in selected patients, this technique could be presented as a viable option to the more invasive surgical procedure, which has been previously the gold standard for the pleural tissue acquisition.

Original languageEnglish
Pages (from-to)1379-1382
Number of pages4
JournalEuropean Review for Medical and Pharmacological Sciences
Issue number9
Publication statusPublished - 2014


  • Endometrial adenocarcinoma
  • Pleural metastases

ASJC Scopus subject areas

  • Medicine(all)
  • Pharmacology (medical)


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