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

OBJECTIVE: 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. METHODS: We reviewed all cases of nonpancreaticobiliary or nonadrenal retroperitoneal lesions prospectively gathered from our endoscopic ultrasound database from April 1995 to September 1999. RESULTS: Of 1120 upper endoscopic ultrasound examinations, 18 (1.6%) involved a retroperitoneal lesion; 16/18 lesions were neoplasms, nine were primary retroperitoneal turners (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. CONCLUSIONS: 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. (C) 2000 by Am. Cell. of Gastroenterology.