Incidental Pancreatic Adenocarcinoma: More Frequent Than Expected?

Aims To describe the frequency and characteristics of incidental PAC sent to our Endoscopy Unit for cytological diagnosis by EUS FNA during the last year.

Methods Retrospective study of incidental PAC diagnosed by radiological techniques and cytologically confirmed by EUS FNA in the Endoscopy Unit at Hospital Clinic of Barcelona from September 2019 to November 2020. PAC was considered incidental when it was diagnosed accidentally, in a setting unrelated to this neoplasm.

Results In the study period, 66 PAC were confirmed by EUS FNA. Five out of them (7.6 %) were found incidentally in the setting of different clinical situations: staging or follow-up of a known neoplasm (lymphoma, endometrial cancer, n = 2), evaluation of urologic disturbances (hematuria, repeated infections of the urinary tract, n = 2) and study before bone marrow transplantation for primary myelofibrosis (=1). Medium size of the tumor was 29.4 x 22 mm (range: 16 x 11mm – 50 x 40 mm). Interestingly, incidental PAC was located in the tail of the pancreas in 3 cases followed by the body and the neck (n = 1 in both locations). No incidental PAC was found in the pancreatic head. Patients underwent surgical resection (n = 2) or palliative chemotherapy for vascular infiltration (n = 2). The patient with concomitant lymphoma is under chemotherapy waiting for surgery after completing it.

Conclusions Incidental PAC represents the 7.6 % of all PACs cytologically confirmed by EUS FNA in our Unit in the last year. According to this, incidental PAC might be nowadays more frequent than expected. Larger series are needed to confirm our results.

Citation Soy G, Olivas I, Bofill A et al. eP392 INCIDENTAL PANCREATIC ADENOCARCINOMA: MORE FREQUENT THAN EXPECTED? Endoscopy 2021; 53: S224.

Publication History

Article published online:
19 March 2021