10 kg tumour involving multiple organs successfully removed at AIIMS Delhi

New Delhi: A 49-year-old woman with recurring Stage 4 rare ovarian cancer, deemed inoperable due to the involvement of multiple organs, successfully underwent a 10-hour surgery to remove a 10-kg tumour at All India Institute of Medical Sciences AIIMS Delhi. 

According to the PTI report, Dr MD Ray, professor of surgical oncology at the Institute of Rotary Cancer Hospital, said the woman was first diagnosed with rare ovarian cancer (granulosa cell) tumour in 2011 and was operated upon in the gynaecology department of AIIMS. 

However, she had to be operated again in 2016 because of a relapse.

"It was a chemo insensitive tumour and thus there were repeated relapses," Dr Ray said.

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"In October this year, she suffered a third relapse with huge weight loss and abdominal pain with repeated vomiting. Because of the huge size of her tumour, there was compression on the small intestine which made her unable to eat. She was surviving only on liquid," Dr Ray said.

The woman seemed inoperable as besides the ovary, multiple sites of the small intestine were also involved. Her anterior abdominal wall, urinary bladder and a part of the large intestine were also affected. CT scan confirmed the involvement of multiple organs, Dr Ray said, news agency PTI reported.

"This made the case very challenging as the surgery required removal of a large portion of small intestine which usually leads to small bowel syndrome, a condition which hampers quality of life because of nutrition deficiency," Dr Ray added.

Another challenge was that the walls of the intestine and bladder had become splayed due to the compression by the tumour, making the repair of the bladder and the intestine all the more difficult, said Dr Rohan Kapoor from Ray's department who assisted in the surgery.

There was also the risk of blood loss because of the injury of the blood vessels during the surgery, Dr Kapoor said.

The tumour weighing around 10 kg was finally removed after a 10-hour surgery on December 2. During the surgery, multiple segments of the small intestine were resected and joined from different sides to maintain continuity, Dr Ray said.

Two segments of the urinary bladder were also removed and reconstructed, and the patient was discharged within a week of the surgery.

"The lesson learnt from this case is that even in repeated relapse cancer conditions involving multiple organs, the patient should not be considered inoperable unless explored by experts at high volume centrse," Dr Ray said.

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