Estrategia diagnóstica post-colonoscopia fallida: biopsia por aguja fina guiada por ultrasonido endoscópico en cáncer de colon

Calixto Duarte-Chang; Julio Zúñiga Cisneros; Ramiro Da Silva Rodriguez

doi:10.47892/rgp.2025.452.1882

Authors

Calixto Duarte-Chang Servicio de Gastroenterología, Hospital San Miguel Arcángel, Panamá, República de Panamá; Sistema Nacional de Investigación (SIN), Panamá, República de Panamá. https://orcid.org/0000-0003-1207-5707
Julio Zúñiga Cisneros Servicio de Gastroenterología, Instituto Oncológico de Panamá. Panamá, República de Panamá. https://orcid.org/0000-0002-4659-3468
Ramiro Da Silva Rodriguez Servicio de Gastroenterología, Hospital San Miguel Arcángel, Panamá, República de Panamá; Sistema Nacional de Investigación (SIN), Panamá, República de Panamá. https://orcid.org/0000-0001-5545-1210

DOI:

https://doi.org/10.47892/rgp.2025.452.1882

Keywords:

Endoscopic Ultrasound-Guided Fine Needle Aspiration, Lower Gastrointestinal Tract, Colonic Neoplasms

Abstract

Endoscopic ultrasound (EUS)-guided sampling is a safe and reliable method for obtaining pathological results of gastrointestinal and adjacent gastrointestinal lesions. Some colon lesions are located in the muscular layer or even in the serosa beneath the mucosa, so conventional colonoscopy with forceps biopsy is often negative. In patients with colon cancer, forceps biopsy during colonoscopy is the current standard diagnostic modality. However, there are cases that are difficult to confirm with forceps biopsy, such as stenosing tumors, or those originating from deep layers. Endoscopic ultrasound (EUS)-guided fine needle biopsy (FNB) is a useful alternative for diagnosis in these cases. We present the successful case of a 62-year-old male with a history of progressive weight loss and a colonic mass at the splenic flexure, whose colonoscopy was unsuccessful, therefore a FNB puncture by EUS was performed, via transgastric route, reaching a histological diagnosis of colon adenocarcinoma. This case highlights the feasibility of FNB by EUS in the acquisition of colonic lesions through the stomach in cases of inconclusive colonoscopy.

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