EUS guided ablation - A possible future of option of treatment for select low risk Pancreatic Neuroendocrine Tumors ("PNET"s)? We now have the ability for earlier detection of even smaller tumors through cross sectional imaging & especially EUS in expert hands enhanced by novel needles which allow for needle biopsy (FNB). The histology rather than cytology precisely determines risk in these tumors less than 1.5cm based on pathologic grade and mitosis. While tumors 1.5cm and larger and higher risk universally require surgery, tumors detected earlier now and some are very low risk for metastasis or may be caught in patients not fit for surgery. EUS guided ablation opens the realm of possibility of minimally invasive treatment in these select patients & warrants further research to optimize its utilization in the algorithm of treatment for select patients. There have been multiple journal publications.
Check out this video of an oral presentation from DDW in 2015. (Dr. Thosani of University of Texas & Dr. Block of Eisenhower Medical Center also presented on the same topic. Dr. Tyberg of Cornell university/Rutgers spoke on endobiliary ablation)
