Peritoneal adenocarcinoma diagnosed by endoscopic ultrasound-guided through-the-needle biopsy

The diagnosis of peritoneal carcinomatosis accompanied by ascites is challenging, particularly when the primary site remains unidentified. While cytological examination of ascites is commonly advocated, the diagnostic sensitivity is approximately 60% [1]. The remaining 40% of patients may require more invasive procedures, such as laparoscopy or laparotomy. In recent years, endoscopic ultrasound (EUS) has extended its reach to peritoneal carcinomatosis, offering enhanced visualization and a minimally invasive approach [2] [3]. In the case presented here, we utilized an innovative technique, EUS-guided through-the-needle (EUS-TTN) biopsy, to facilitate the pathological diagnosis of peritoneal carcinomatosis.