Use of endoscopic ultrasound-guided fine needle aspiration to select a treatment plan in a patient with gallbladder carcinoma and a hepatic lesion

Abstract

A 66-year-old woman was referred to our hospital for further examination of gallbladder cancer. Contrast-enhanced computed tomography (CT) showed a ring formed by an enhanced mass measuring 10 mm in diameter in segment II of the liver, accompanied by the gallbladder cancer. Hepatic metastasis from the gallbladder cancer was suspected based on the findings of several imaging examinations. An adequate sample from the small lesion could not be obtained using abdominal ultrasound-guided biopsy because it was located deep under the skin. However, the lesion could be clearly visualized on endoscopic ultrasound because of its location near the stomach. Therefore, we performed ultrasound-guided fine needle aspiration (EUS-FNA) , and the lesion was diagnosed as an inflammatory mass. Surgery was selected as treatment for gallbladder carcinoma. According to a report by John DeWitt et al, the sensitivity for diagnosis of a malignant hepatic lesion by EUS-FNA was 82-94%. Our findings suggest that EUS-FNA may be useful for the histological diagnosis of hepatic lesions located near the stomach.