World's First Face and Neck Tumor Successfully Removed At Sir Ganga Ram Hospital

New Delhi: A 60-year-old male patient was referred to Head & Neck surgery OPD of Sir Ganga Ram Hospital with chief complaints of difficulty in breathing and swallowing (more with solid food than liquid) as well as change in voice.

Initially he had difficulty in breathing while lying down, then gradually he developed difficulty in upright position, as well. He was evaluated by Head & Neck surgery team and advised for MRI and core needle biopsy. In MRI, there was a big tumour of size about 9-10cm which was pressing upon the posterior aspect of nose as well as windpipe and foodpipe resulting in difficulty in breathing and swallowing. Diagnosis of Rhabdomyoma was made with core needle biopsy.

The tumour was involving the whole of the skull base (area beneath the brain) and a large part of neck, as well. It is a very rare tumour and no reported case of Rhabdomyoma of comparable size in this part of neck (which is called parapharyngeal space) has been found in India in literature. Most common site for such kind of tumour is heart. The only management of this tumour is surgery so surgery was planned very carefully because-

1. Tumour was in close approximation to large blood vessels going to brain and any injury to them can cause paralysis or death.

2. Risk of excessive bleeding

3. Injury to nerve causing facial paralysis and loss of voice.

4. Damage to foodpipe.

Meticulous planning was done and successful removal of the tumour has been performed without any complication. In our knowledge, it is the first successful resection of this tumour. Now after two months of surgery, the patient is comfortable and in proper follow up care.

Surgical team included: Dr. Sangeet Agarwal, Dr. Jyoti Agarwal, Dr. Arushi Gupta, Dr. Arpan Saha , Anaesthesia team- Dr. Jayashree Sood, Dr. Rashmi Jain.