Insulin Washout in Fine-Needle Aspiration Fluid for Preoperative Diagnosis of Suspicious Lesion in Patients with Insulinoma: A Case Report

ABSTRACT

Insulinomas, the most common neuroendocrine tumors of the pancreas, are usually solitary in nature. Yet, they may be difficult to localize. A 29-year-old female patient with neurologic complaints including drowsiness, meaningless speech and temporary dementia (not recognizing her relatives), was evaluated for hypoglycemia. According to the critical laboratories investigations, the patient was found to be having hyperinsulinemic hypoglycemia. After diagnosing insulinoma by biochemical tests, the tumor was localized using endoscopic ultrasonography and fine needle aspiration biopsy was performed on the insulin washout material to obtain a prompt confirmation. After localization of the tumor, subtotal pancreatectomy was performed. The patient’s symptoms were relieved and did not re-occur. Thus, this case report suggests that the insulin washout from fine needle aspiration biopsy can be successfully employed during ndoscopic ultrasonography to obtain a hasty diagnosis since it delivers faster results and is a much more convenient approach than the pathological examinations. It promptly confirms the tumor site and may, therefore, be employed in cases of difficult tumor localization.