Doctors at KIMS hospital successfully remove Paraganglioma tumour from Zambian woman

Dr. Ramya Valiveru, an endocrine surgeon from KIMS Kondapur, successfully treated the patient by performing a complex surgery.

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According to her, the occurrence rate of that Paraganglioma tumour is only two in one million population.

The doctor said the patient was referred with primary complaints of severe fluctuating hypertension and uncontrolled giddiness. The government of Zambia referred her to the Endocrine Surgery department of KIMS Hospital Kondapur.

The patient had been suffering from severe recurrent headaches, episodes of anxiety, palpitations, and increased sweating for more than five years. She was evaluated in Zambia and was found to have a large 8.5x7.5 cm tumour in her abdomen.

"The tumour is a very rare type that was found to produce very high amounts of a hormone called noradrenaline. Also, the location of the tumour was in a critical zone, behind the large important vessels like Inferior Vena Cava and Aorta. The blood vessels (veins) to both kidneys were travelling on the front of the tumour, the right kidney artery was travelling behind the tumour. All vessels were closely abutting the tumour," explained Dr Ramya.

When the patient came to KIMS, she was noticed to have uncontrolled hypertension. She underwent extensive evaluation and optimal preparation for surgery. "Pre-operative preparation in such cases is the key to successful surgery. Her endocrine control, hypertension control, and optimization were successfully done with alpha and beta blockade by Dr. Krishna Reddy, Consultant Endocrinology. Intra-operative fluctuations of BP and heart rate management is very challenging in this case.

According to Dr Ramya, surgery for Paragangliomas is different from the removal of other tumours. "The tumour can release hormones in a large quantity when touched, and cause a heavy load on the heart. So, we had to perform the surgery so meticulously, and carefully handle the tumour, without damaging the kidneys and the great vessels. The experienced team of anesthetists headed by Dr. Veera Bhadra Rao managed the patient during the surgery and the Postoperative Intensive care stay," she said.

The patient had a smooth recovery in the post-operative period and has been discharged in stable condition.