How to distinguish pancreatic tumors and assess the necessity for biopsy

Endoscopic ultrasonography (EUS) is a valuable and widely used tool for evaluating pancreatic tumors. Accurate decision-making during EUS procedures, particularly for differentiating between benign and malignant lesions based on imaging characteristics and assessing the need for tissue sampling, is crucial. This review provides a comprehensive overview of pancreatic tumor features observed during EUS and highlights the key criteria for distinguishing between malignant and benign conditions. Additionally, we discuss the indications for fine-needle aspiration or biopsy to obtain histopathological and genetic confirmation. Improving our understanding of these critical aspects can help improve diagnostic accuracy and guide clinicians in determining the most appropriate management strategies for patients with pancreatic tumors.