EUS-FNA of a portal vein thrombosis in a patient with a hidden hepatocellular carcinoma: confirmation technique after contrast-enhanced ultrasound

Abstract

The differentiation of a malignant from a benign portal vein thrombosis is of paramount importance in the management of a patient with cirrhosis and a potentially curable hepatocellular carcinoma. Contrast-enhanced ultrasound has led to significant progress in the diagnosis of malignant portal vein thrombosis [1]. More invasive techniques, such as transabdominal ultrasound-guided fine-needle aspiration cytology (TUS-FNA), have proved to be feasible in this setting, but they are not without complications and are sometimes technically not possible [1]. The use of endoscopic ultrasound-guided fine-needle aspiration cytology (EUS-FNA) has been rarely reported in this setting [2] [3], but in no case after inconclusive results of contrast-enhanced ultrasound.