Clinical utility of endoscopic ultrasound and endscopic ultrasound-guided fine needle aspiration in retroperitoneal neoplasms.

Abstract

Nonpancreatic, retroperitoneal tumors are a relatively uncommon clinical problem. With the advent of endoscopic ultrasound and endoscopic ultrasound-guided fine needle aspiration, gastroenterologists may be called upon to assist in the diagnosis and management of these lesions. This paper reviews the spectrum of upper retroperitoneal lesions encountered at a single institution using endoscopic ultrasound. We reviewed all cases of nonpancreaticobiliary or nonadrenal retroperitoneal lesions prospectively gathered from our endoscopic ultrasound database from April 1995 to September 1999. Of 1120 upper endoscopic ultrasound examinations, 18 (1.6%) involved a retroperitoneal lesion; 16/18 lesions were neoplasms, nine were primary retroperitoneal tumors (four lymphomas, two leiomyosarcomas, two extraadrenal paraganglionomas, one leiomyoma), and seven were metastatic cancers. There was one fibrous mass and one mass-like abscess. Endoscopic ultrasound-guided fine needle aspiration was used in 15/18 cases. The management of 16 patients was significantly affected by the results of endoscopic ultrasound and biopsy. Although it is not a frequent indication, assessing upper retroperitoneal tumors with endoscopic ultrasound and endoscopic ultrasound-guided fine needle aspiration can significantly affect the subsequent management of patients with these lesions.