Endoscopic ultrasound-guided fine-needle aspiration of periarterial tumor extension from mucinous cystic carcinoma.

A 57-year-old woman with abdominal pain was admitted to our hospital for close examination. The imaging studies revealed a cystic tumor in the pancreatic tail. The cystic mass, 6 cm in size, was accompanied by internal mural nodules ([Fig. 1 a]), and periarterial tumor extension from the splenic artery to the celiac and common hepatic arteries with encasement ([Fig. 1 b, c]). Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of cystic tumors is a safe technique [1]. However, there are still some concerns about peritoneal dissemination after EUS-FNA of cystic masses [2]. In this context, we decided to perform EUS-FNA of the periarterial tumor extension around the splenic artery ([Fig. 2 a], [Video 1]) instead of puncturing the cystic mass.