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Endoscopic Ultrasound Case 1
A 73 year old female found incidentally with pancreatic cysts on CT scan during work-up of mildly elevated liver enzymes. She was initally told she had benign pseudocysts. However, subsequent endoscopic ultrasound (EUS) with fine needle aspiration showed elevated CEA >1900 and a dilated pancreatic duct consistent with intraductal papillary mucinous neoplastic cysts. A small 1.3cm mass was also seen at the head of the pancreas which was missed on both transabdominal or conventional ultrasound and multidetector CT scan with pancreatic protocol. Biopsy of this mass by EUS was positive for pancreatic cancer.
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| Fig 1. CT scan showing pancreatic cysts | Fig 2. EUS with aspiration of cystic fluid | |
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| Fig 3, 4. EUS with fine needle biopsy of early pancreatic tumor missed on CT scan | ||