We read with interest the article by Park et al published in Gastrointestinal Endoscopy that described a case of a hypervascular and solid-appearing serous cys-tadenoma (SCA) of the pancreas. In the CT and US literature, hypervascuiarity is a known characteristic of SCAs2 and has been observed by us and others on EUS.3 This can lead to confusion with other hypervascular neoplasms, such as neuroendocrine tumors. Because of their microcystic architecture, SCAs can have a "pseudo-solid" appearance. Truly solid variants have also been described, adding further diagnostic difficulty. Cytology is usually nondiagnostic, and FNA for cyst-fluid analysis is not possible in the absence of larger cyst compartments. In our opinion, EUS-guided Tru-cut biopsies should be performed in these cases.
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