In this review, we explore the evolving role of endoscopic ultrasound (EUS) in diagnosing and managing pancretobiliary malignancies. For solid pancreatic lesions, techniques like fine-needle biopsy (FNB), contrast-enhanced EUS (CE-EUS), and macroscopic on-site evaluation (MOSE) improve sample quality and diagnostic accuracy. In cystic pancreatic lesions, fine-needle aspiration (FNA), molecular testing, and confocal laser endomicroscopy (nCLE) aid in distinguishing benign from malignant cysts. For cholangiocarcinoma, EUS guided sampling is more accurate than CT in assessing distal lesions and lymph node metastases, while combining EUS with magnetic resonance cholangiography (MRC) enhances diagnostic sensitivity. In gallbladder cancer, EUS surpasses CT and MRI in detecting lymphadenopathy and staging tumors. EUS-FNB (Fine needle biopsy) improves biopsy accuracy, especially for unresectable cases. These advancements highlight EUS as a critical tool for early cancer detection, staging, and tissue acquisition. Beyond diagnosis, EUS plays a pivotal therapeutic role in managing complications such as malignant biliary obstruction and gastric outlet obstruction, offering minimally invasive alternatives like EUS-guided biliary drainage and gastroenterostomy with high clinical success and improved patient outcomes.

In this review, we explore the evolving role of endoscopic ultrasound (EUS) in diagnosing and managing pancretobiliary malignancies. For solid pancreatic lesions, techniques like fine-needle biopsy (FNB), contrast-enhanced EUS (CE-EUS), and macroscopic on-site evaluation (MOSE) improve sample quality and diagnostic accuracy. In cystic pancreatic lesions, fine-needle aspiration (FNA), molecular testing, and confocal laser endomicroscopy (nCLE) aid in distinguishing benign from malignant cysts. For cholangiocarcinoma, EUS guided sampling is more accurate than CT in assessing distal lesions and lymph node metastases, while combining EUS with magnetic resonance cholangiography (MRC) enhances diagnostic sensitivity. In gallbladder cancer, EUS surpasses CT and MRI in detecting lymphadenopathy and staging tumors. EUS-FNB (Fine needle biopsy) improves biopsy accuracy, especially for unresectable cases. These advancements highlight EUS as a critical tool for early cancer detection, staging, and tissue acquisition. Beyond diagnosis, EUS plays a pivotal therapeutic role in managing complications such as malignant biliary obstruction and gastric outlet obstruction, offering minimally invasive alternatives like EUS-guided biliary drainage and gastroenterostomy with high clinical success and improved patient outcomes.

Solid pseudopapillary neoplasms (SPNs) are rare, low-grade malignant tumors of the pancreas comprising 1%-2% of pancreatic neoplasms. Predominantly affecting young women, these tumors are typically slow-growing and often discovered incidentally during imaging for non-specific symptoms. This case describes a young female patient who presented with acute-onset back pain without prior significant medical history or trauma. Initial evaluation suggested a musculoskeletal etiology; however, persistent symptoms prompted further imaging, which revealed a pancreatic mass. Subsequent diagnostic workup, including cross-sectional imaging and histopathological analysis, confirmed the diagnosis of an SPN of the pancreas. The patient underwent surgical resection with a favorable postoperative recovery. This case highlights the atypical presentation of SPN as isolated back pain and underscores the importance of maintaining a broad differential diagnosis when evaluating persistent, unexplained pain in young patients.

Dysphagia is an uncommon presenting symptom of lung cancer, occurring in a minority of patients and often leading clinicians to pursue gastrointestinal etiologies first. However, thoracic malignancies, particularly small cell lung carcinoma (SCLC), may occasionally present with esophageal symptoms due to mediastinal involvement. Upper endoscopy and upper endoscopic ultrasound play a role in patients with esophageal extrinsic compression and/or local invasion. Herein, we describe a case of a 29-year-old man with no history of tobacco use who presented with progressive dysphagia and significant weight loss and was diagnosed with small-cell lung cancer.