Usefulness of endoscopic ultrasound-guided fine needle aspiration for hepatic tumors in which percutaneous biopsy is difficult

Abstract

Ultrasound-guided percutaneous biopsies are regularly performed for hepatic tumors requiring diagnostic histological examinations. However, in some patients, percutaneous biopsies are difficult to perform. We retrospectively studied 16 patients who underwent hepatic tumor biopsy using endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) between 2013 and 2016 because percutaneous biopsy was difficult to perform. The patients included nine men and seven women ; their mean age was 67.5 years (range, 43-82 years) . Reasons for avoiding percutaneous liver biopsy were ascites in 12 patients, Chilaiditi syndrome in 2, caudate lobe tumors in 2, and small tumors (＜15 mm) in 2 (with duplications) . The mean diameter of target lesions was 30.3 mm. The lesions were more commonly located in the left lobe in 12 patients, right lobe in 2, and caudate lobe in 2. Making a histological diagnosis was possible in all patients, and immunostaining was performed in 13 patients (81%) . No complications (bleeding, infection, or perforation) were observed. EUS-FNA for hepatic tumors is a safe and useful method. When performing percutaneous biopsy is difficult, EUS-FNA may be an effective alternative and should be considered.