When a 32-year-old Nepali woman could hardly deal with a shooting pain in her big belly, little did she realise that a tumour was ballooning up inside her stomach. When she was diagnosed, no hospital in Kathmandu wanted to risk a surgery to take it out. When she came to Delhi, most hospitals were wary too. So when doctors at the CK Birla Hospital agreed, she saw hope. But the doctors themselves were in for a major surprise. Her tumour was not just rare but the size of a football which they have now removed through a rare surgery. It weighed all of 4 kg!
According to Dr Amit Javed, Director of the Department of Advanced Surgical Sciences and Oncology Surgeries, the tumour was mesenteric and was taken out through a laparoscopic surgery two months ago and the patient has resumed normal life. Mesenteric tumours are rare and consist of a heterogeneous group of lesions. “Masses may arise from any of the mesenteric components, like peritoneum, lymphatic tissue, fat and connective tissue. Cellular proliferation can also arise from infectious or inflammatory processes. They can be classified as solid or cystic, benign or malignant. Mesenteric tumours are usually discovered incidentally or during investigation of non-specific symptoms. Therapeutic management options vary widely depending on the nature of the lesion; they range from simple observation or medical therapy to surgery,” he said.
“I was quite worried when I got to know about my condition. A number of hospitals in Kathmandu and even in Delhi were not ready to go ahead with the surgery due to the size of the tumour. I was very concerned about quick recovery and Dr Javed assured me that the tumour could be removed with minimal scars and pain, which made me confident about undergoing a laparoscopic surgery. It took four days to recover and I was discharged after a week,” said the patient.
When doctors conducted tests and evaluated her condition, she was diagnosed with a giant 4 kg tumour that was 40 cm long. The challenge for Dr Javed and his team was to remove the tumour from the stomach while safely preserving the intestine. Dr Javed said that the surgery was performed by a keyhole laparoscopy technique and the 4 kg tumour was extracted via a pfannenstiel incision, usually made during a caesarean section for delivery of babies. This procedure resulted in no scarring on the abdomen and ensured minimal pain.
“It was a very complex surgery because of the large size of the tumour, which occupied the abdominal cavity, giving us very little space to perform the laparoscopic surgery. In addition, the tumour was very large and heavy, which made it difficult to handle and perform the dissection laparoscopically. The delivery of the specimen was like delivering a large size baby as in a caesarean section,” Dr Amit added.
The patient has now fully recovered and is leading a normal life.