Endoscopic ultrasonography as a comprehensive tool in the evaluation of pancreatic lesions

Abstract

This article expands upon of endoscopic ultrasound’s (EUS) role in the evaluation of pancreatic lesions, building on findings presented by Ayesha et al and Tasneem et al regarding neuroendocrine tumors. We emphasize the diagnostic and therapeutic utility of EUS not only in solid pancreatic tumors but also in the increasingly prevalent cystic lesions, highlighting its particular relevance in resource-limited settings. By integrating high-resolution imaging, tissue acquisition, biomarker analysis, and minimally invasive interventions into a single platform, EUS addresses key diagnostic and therapeutic challenges, reducing the need for multiple costly procedures and enabling effective management even when access to advanced technologies is limited.

Keywords: Endosonography; Pancreatic cyst; Pancreatic neoplasms; Endoscopic ultrasound-guided fine needle aspiration; Neuroendocrine tumors

Core Tip: Endoscopic ultrasound (EUS) is a minimally invasive, high-resolution modality with growing relevance in the diagnosis and management of pancreatic diseases. In solid tumors like neuroendocrine tumors, EUS combined with fine-needle biopsy enables accurate histological characterization and prognostic stratification. In cystic lesions, EUS-guided fluid analysis using accessible biomarkers such as carcinoembryonic antigen and glucose allows for clinically meaningful subclassification. Additionally, EUS provides therapeutic options including drainage of fluid collections, celiac plexus neurolysis, and tumor ablation. This integrated versatility makes EUS particularly valuable in resource-constrained healthcare settings.