The No Endosonographic Detection of Tumor (NEST) Study: a Case Series of Pancreatic Cancers Missed on Endoscopic Ultrasonography

Manisha Bhutani, Frank G. Gress, Marc Giovannini, Richard A. Erickson, M.F. Catalano, Amitabh Chak, P. Deprez, Douglas O. Faigel, Cuong V. Nguyen

Endoscopy · 2004 · 151 citations · 0 references

Abstract

EUS is not a foolproof method of detecting a pancreatic neoplasm. Possible associated factors that may increase the likelihood of a false-negative EUS examination include chronic pancreatitis, a diffusely infiltrating carcinoma, a prominent ventral/dorsal split and a recent episode (< 4 weeks) of acute pancreatitis. If there is a high clinical suspicion of pancreatic neoplasm, if EUS and other imaging methods are negative, and if the patient does not undergo surgery, this study suggests that a repeat EUS after 2-3 months may be useful for detecting an occult pancreatic neoplasm.