EUS-guided ethanol ablation in patients with solid pseudopapillary neoplasm: a four-case series

Background/aims: Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare tumor with low malignant potential, though 10–15% may show invasive or metastatic behavior. This study aimed to evaluate the safety and efficacy of endoscopic ultrasound-guided ethanol ablation (EUS-EI) in patients with SPN who were not surgical candidates. Methods: Four patients with SPN who declined or were ineligible for surgery underwent EUS-EI at Aichi Cancer Center. Technical and clinical outcomes, as well as adverse events, were assessed. Results: Technical success was achieved in all patients (100%). Clinical success was observed in three patients (75%), including two with complete ablation and one with significant tumor reduction. No major adverse events or tumor recurrence occurred during follow-up. Conclusions: EUS-EI may be a safe and effective alternative for managing SPN in non-surgical candidates.