Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Feb 10, 2016; 8(3): 192-197
Published online Feb 10, 2016. doi: 10.4253/wjge.v8.i3.192
Endoscopic ultrasound-guided ethanol ablation of pancreatic neuroendocrine tumours: A case study and literature review
Elia Armellini, Stefano F Crinò, Marco Ballarè, Socrate Pallio, Pietro Occhipinti
Elia Armellini, Stefano F Crinò, Marco Ballarè, Socrate Pallio, Pietro Occhipinti, Gastroenterology Division, Azienda Ospedaliero Universitaria “Maggiore della Carità”, 28100 Novara, Italy
Author contributions: Armellini E performed the endoscopic procedures; Ballarè M, Pallio S and Occhipinti P collected and analyzed the data; Armellini E and Crinò SF wrote the paper and contributed equally to this manuscript.
Institutional review board statement: This case report was exempt from the Institutional Review Board standards at our Institution.
Informed consent statement: The patient involved in this study gave his written informed consent authorizing use and disclosure of his protected health information.
Conflict-of-interest statement: All the authors have no conflicts of interests to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Elia Armellini, MD, Gastroenterology Division, Azienda Ospedaliero Universitaria “Maggiore della Carità”, Corso Mazzini 18, 28100 Novara, Italy. elia_armellini@hotmail.com
Telephone: +39-32-13733206 Fax: +39-32-13733345
Received: May 8, 2015
Peer-review started: May 11, 2015
First decision: July 25, 2015
Revised: August 20, 2015
Accepted: October 12, 2015
Article in press: October 13, 2015
Published online: February 10, 2016
Abstract

Here we offer a review of the literature regarding endoscopic ultrasound-guided ethanol ablation for pancreatic neuroendocrine tumours and describe the case of a cystic tumour completely ablated after a multisession procedure. A total of 35 PubMed indexed cases of treated functioning and non-functioning pancreatic neuroendocrine tumours resulted from our search, 29 of which are well-documented and summarised. Endoscopic ultrasound-guided ethanol ablation appears as a local, minimally invasive treatment of pancreatic neuroendocrine tumours, suitable for selected patients. This technique appears feasible, relatively safe and efficient, especially when applied to symptom relief in functioning tumours, aiming at loss of endocrine secretion. For non-functioning tumours, where the goal is complete tissue ablation, eus guided ethanol ablation can provide good results for patients who are unfit for surgery or for those who refuse surgical resection. Its role in “fit for surgery” patients requires assessment through further studies.

Keywords: Endoscopic ultrasound, Pancreatic neuroendocrine tumour, Endoscopic ultrasound-guided injection, Ethanol, Tumour ablation

Core tip: We report a complete review of the literature about endoscopic ultrasound-guided ethanol ablation for pancreatic neuroendocrine tumours. The case of a cystic tumour completely ablated after a multisession procedure is described. On long term follow-up a durable remission of the tumour was obtained; a complete image gallery showing the pre and post-treatment appearance is available. The technical aspects, clinical success and complication rates related to this kind of procedures are described.