Endoscopic ultrasound-guided ethanol ablation of pancreatic neuroendocrine tumours: A case study and literature review

Table 1 World Health Organization classification of pancreatic neuroendocrine tumors

Grade	Ki-67 index (%)	Mitotic count/10 HPF
G1	≤ 2	< 2
G2	3-20	2-20
G3	> 20	> 20
TNM	Size (cm)	Muscularis propria invasion
T1a	< 1	_
T1b	1-2	_
T2	> 2	+

Accordingly to the WHO classification 2010, the higher grade is assumed if the Ki-67 index and mitotic count differ; in the WHO 2010 TNM, the tumor is classified as T2 if it is larger than 2 cm in diameter or if it invades the muscularis propria. T3 and T4 tumors are locally aggressive tumors. WHO: World Health Organization; HPF: High-power field.

Table 2 Patient demographic information and baseline characteristics of the tumours

No. of patients1	27
Age, yr
Mean (range)	59 (27-89)
Sex, male/female	10-17
No. of tumors	30
Functioning	19
Non functioning	11
Type of functioning tumor
Insulinoma	18
Vipoma	1
Diameter, mm
Mean (range)	12.5 (5-22)

¹Including described case.

Table 3 Procedural outcomes

No. of treatment session per tumor
Mean (range)	1.43 (1-3)
Alcohol volume, mL
Mean (range)	1.83 (0.18-8)
Technical success, n (%)	30/30 (100)
Clinical success1, n (%)
Functioning	19/19 (100)
Non functioning2	7/10 (70)
Adverse events3, n (%)	11 (25.5)
Early (within one week), n (%)	9 (21)
Pancreatic necrotic lesion	1 (2.3)
Mild pancreatitis	7 (16.2)
Abdominal pain	1 (2.3)
Late, n (%)	2 (4.6)
Hematoma and ulceration of the duodenal wall	1 (2.3)
Main pancreatic duct stricture	1 (2.3)
Follow-up, mo
Mean (range)	13.4 (2-38)

¹Clinical success: Symptom resolution for functioning tumours and radiological ablation for non-functioning tumour;

²One non functioning tumor was lost to follow-up;

³Adverse events percentage is intended in relation to procedure number.