Transduodenal EUS-guided FNA of the right adrenal gland

BackgroundEUS-guided FNA is commonly performed to sample peri-intestinal targets such as the pancreas, lymph nodes, and the left adrenal gland. To our knowledge, EUS-guided FNA of the right adrenal gland has not been reported.ObjectiveOur purpose was to determine the feasibility and success in sampling an enlarged right adrenal gland.Study DesignObservational study.SettingTertiary referral center.PatientsConsecutive patients that underwent EUS-guided FNA of the right adrenal gland.ResultsOver a span of 3.5 years, 4 patients underwent transduodenal EUS-guided FNA of the right adrenal gland with a curvilinear echoendoscope. Four passes were performed in all cases, and the diagnosis was rendered on the first pass. The posterior wall of the descending duodenum was the port of entry of the needle. Three of the patients had metastatic lung cancer to the right adrenal gland; one was proven by surgical histopathologic examination. One patient had a benign aspirate consistent with angiomyolipoma. None of the patients had any minor or major complications.LimitationsObservational study, small sample size.ConclusionsTransduodenal EUS-guided FNA of the right adrenal gland is feasible and safe. Future large-scale studies are needed to replicate our findings and to determine the rate of successful identification and sampling of the right adrenal gland with the curvilinear echoendoscope.