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Pancreatic Cancer · Journal article
Den Open · April 28, 2026
Early or partial results. Treat as a signal, not a conclusion.
This case report describes a 70-year-old woman who developed a 30-mm gastric wall mass 2 years after EUS-FNB for pancreatic adenocarcinoma, initially suspected to be needle tract seeding but ultimately diagnosed as desmoid fibromatosis following partial gastrectomy. The report highlights that alternative diagnoses including desmoid fibromatosis must be considered when lesions arise along EUS-FNB puncture tracts.
Case report. A 70-year-old Japanese woman with no family history of FAP or anti-estrogen therapy, initially diagnosed with 10-mm pancreatic head adenocarcinoma treated with neoadjuvant GS chemotherapy and pancreaticoduodenectomy, who declined adjuvant chemotherapy and developed gastric mass at 2-year follow-up. Intervention: Partial gastrectomy for 30-mm gastric wall mass. n = 1.
Primary pancreatic cancer was 10-mm, cT1bN0M0, Stage IA, subsequently resected as pT3N0M0, Stage IIA A 30-mm gastric submucosal mass developed 2 years postoperatively along the prior EUS-FNB puncture route Three separate EUS-FNB sessions using 19-G, 22-G, and 25-G needles failed to yield definitive diagnosis due to extreme lesion hardness
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Clinicians should recognize that gastric wall masses arising along EUS-FNB puncture tracts may represent benign entities such as desmoid fibromatosis rather than needle tract seeding, particularly when repeated biopsies are non-diagnostic and demonstrate extreme tissue hardness. Surgical resection may be required for both definitive diagnosis and treatment when malignancy cannot be excluded.
Single case report documenting desmoid fibromatosis mimicking needle tract seeding after EUS-FNB, illustrating diagnostic complexity but providing no quantitative evidence.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should recognize that gastric wall masses arising along EUS-FNB puncture tracts may represent benign entities such as desmoid fibromatosis rather than needle tract seeding, particularly when repeated biopsies are non-diagnostic and demonstrate extreme tissue hardness. Surgical resection may be required for both definitive diagnosis and treatment when malignancy cannot be excluded.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) is widely used for the pathological diagnosis of pancreatic diseases. However, needle tract seeding (NTS) remains a clinical concern, particularly when the puncture route is not included in the surgical resection field. We report a case in which distinguishing NTS from other pathologies was challenging. A woman in her 70s underwent EUS-FNB via the gastric antrum for a 10-mm pancreatic head lesion, which was diagnosed as adenocarcinoma (cT1bN0M0, Stage IA). She subsequently underwent pancreaticoduodenectomy (pT3N0M0, Stage IIA) without adjuvant chemotherapy. Two years postoperatively, a 30-mm submucosal tumor was detected in the stomach. Although positron emission tomography-computed tomography demonstrated fluorodeoxyglucose uptake, three separate sessions of EUS-FNB failed to yield a definitive diagnosis, with NTS being strongly suspected. Partial gastrectomy was performed. Histopathology revealed a fascicular proliferation of spindle-shaped cells with nuclear β-catenin positivity, leading to the diagnosis of a desmoid fibromatosis (DF). This case underscores that although NTS should be considered when a lesion arises along the EUS-FNB puncture tract, alternative diagnoses, including DF, must also be carefully evaluated.
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