EUS is often employed in the evaluation of suspected pancreas cancer. A tissue diagnosis can be made during EUS, and high resolution images can be obtained which can help in patient management.

Vascular anatomy is important when staging a pancreatic tumor. According to the AJCC Cancer Staging Handbook (1), a T4 lesion, which is an unresectable presentation, occurs when the celiac or superior mesenteric arteries are involved by the cancer.

This issues featured movie shows an example of a pancreas tumor that was locally advanced at presentation. The common bile duct was obstructed and the superior mesenteric vein has apparent lateral involvement for about a centimeter. More problematic was the finding of tumor infiltration into the superior mesenteric artery (SMA).

Figure 1	Figure 2	Figure 3

References:

1. AJCC Cancer Staging Handbook, 6th Edition Greene, FL, Page,DL, Fleming, ID, Fritz, AG, Balch, CM, Haller, DG and Morrow, M, editors. Springer Verlag 2002, New York, NY