[Endoscopic ultrasound in small pancreatic tumors]

32 of 89 pancreatic tumors examined by endoscopic ultrasonography (EUS) from January 1986 to February 1990 had a diameter of 3 cm or less. The final diagnosis of a malignant (n = 28) or benign (n = 4) pancreatic neoplasma was achieved by operation, puncture or autopsy. The accuracy of EUS (100%) was higher than for ultrasound (61%), computed tomography (64%) or endoscopic-retrograde cholangiopancreatography (84%). The echopattern of the small pancreatic carcinomas showed, compared to larger neoplasms, less often regressive changes (21 vs. 77%) and a well demarcated or smooth tumor margin (25 vs. 2%). However, it is not possible to differentiate reliably a small malignant from a benign pancreatic tumor by the echofeatures alone. Since most pancreatic tumors are large at the time of clinical presentation, they can be visualized by conventional imaging methods in most cases. EUS adds clinically important information to the diagnosis of pancreatic carcinoma especially in small tumors.