Endoscopic ultrasound (EUS) is an imaging technique that combines endoscopy and high-frequency ultrasound, allowing precise evaluation of the digestive wall and adjacent structures.Digestive tumors pose a major diagnostic challenge due to their location and histological variability. EUS has become an essential tool for assessing parietal and submucosal tumors of the gastrointestinal tract, as well as for guiding biopsies for diagnostic purposes.

This is a descriptive retrospective study conducted in our department over a 4-year period, from October 2021 to August 2025.It included all patients with a clinically or radiologically suspected digestive tumor who underwent endoscopic ultrasound in our institution.Clinical, radiological, EUS, and histological data were collected and analyzed.

In this study, 57 patients with a clinically or radiologically suspected digestive tumor were included, all of whom underwent endoscopic ultrasound in our department. The mean age was 63.78 years (range: 31–87 years), with a male predominance: 30 men (52.63%) and 27 women (47.36%), M/F ratio  1,1.

Regarding the indication for EUS, 50 patients (87.71%) underwent the procedure for histological confirmation via fine-needle aspiration, while 7 patients (12.25%) underwent EUS for tumor staging.

The most frequent tumor locations were the pancreas, with 50 cases (87.71%), distributed as follows: 70% in the pancreatic head, 14% in the head and isthmus, 4% in the pancreatic tail, and 12% in the uncinate process. Other locations included the rectum (2 cases, 3.5%), the stomach (4 cases, 7%), and the ampulla of Vater (1 case, 1.75%).

The average tumor size was 30.5 mm × 30.1 mm. concerning echogenicity, tumors were heterogeneous in 36 cases (63.15%), hypoechoic in 16 cases (28.07%), and hyperechoic in 2 cases (3.5%).

EUS demonstrated locoregional invasion in 29 cases (50.87%) and identified lymph node metastases in three patients that had not been detected on CT. Fine-needle aspiration was carried out in 50 patients (87.71%).

Adenocarcinoma was the most common histological type, found in 44 patients (88%). A gastrointestinal stromal tumor (GIST) was identified in 1 patient (2%). Two cytological samples (4%) revealed no tumor cells within the sample limits, while three cytological samples (6%) were inconclusive.

Endoscopic ultrasound is an essential tool for diagnosing and monitoring tumor pathology. It allows precise exploration of internal organs, particularly for digestive cancers, by locating tumors and assessing their extent. It also facilitates targeted biopsies and helps determine appropriate treatment. Thus, EUS plays a key role in tumor management, providing accuracy and therapeutic guidance.