Endoscopic Ultrasound-Guided Radiofrequency Ablation for an Adrenocorticotropic Hormone-Secreting Pancreatic Neuroendocrine Tumor on Antiplatelet Therapy

ABSTRACT Endoscopic ultrasound (EUS)-guided radiofrequency ablation (RFA) has been used for thermal destruction of precancerous insulinomas and nonfunctioning pancreatic neuroendocrine tumors (pNETs) by coagulative necrosis. We report a case of a critically ill patient with an adrenocorticotropic hormone (ACTH)-secreting pNET treated with EUS-guided RFA (EUS-RFA) while on a P2Y12 antiplatelet after temporary stabilization on a titratable continuous etomidate infusion. This case demonstrates the novelty of EUS-RFA as a procedural treatment option for functional pNETs in critically ill, nonsurgical candidates on antiplatelet therapy.