16.7 kgs gunny bag tumour removed from 27-year-old man's back at FMRI Gurugram
Gurugram: In an extraordinary display of medical expertise and teamwork, Fortis Memorial Research Institute, Gurugram, has achieved a significant milestone by successfully removing a massive 16.7 kgs, 58×50 cms non-cancerous tumor from the back of a 27-year-old man.
The patient, who hails from the Pacific Islands, had been living with the tumor since 2008. The team of doctors led by Dr Niranjan Naik, Senior Director and Dr Sushil Kumar Jain, Additional Director, Surgical Oncology, Fortis Memorial Research Institute removed the huge tumor from his back, which was hanging like a gunny bag, with the help of multipronged approach.
He had visited several hospitals in different countries for treatment but was denied surgery due to the high risk associated with the tumor’s size and complexity. After complete evaluation at Fortis Gurugram, the preparatory phase included two procedures to block 11 significant blood vessels to mitigate the risk of excessive bleeding during the tumor removal.
The tumor had multiple large arterial and venous channels, covering the entire back of the patient, and exposing approximately 18% of the body surface as a raw area. Covering this area post-surgery posed a significant challenge. Utilising healthy skin from both thighs for a skin graft would result in an additional raw area, increasing the total exposed surface to about 35-36%. To avoid this, surgeons opted to harvest the graft from the tumor itself, as it was non-cancerous.
This innovative approach allowed for the successful coverage of the patient's entire back using the tumor-derived skin graft. The procedure lasted 10 hours, and remarkably, the patient was discharged in just four days in a stable condition.
Giving details of the case, Dr Niranjan Naik, Senior Director, Surgical Oncology, Fortis Memorial Research Institute, Gurugram said, “Giant neurofibroma is a type of peripheral nerve tumor that forms soft bumps on or under the skin which can grow to very large size gradually over a longer period. Main cause for this tumor occurrence is genetic abnormalities.
These tumors can hamper the quality of life of the patient by restricting mobility, causing cosmetic disfigurement, discomfort or pain and occasionally heavy bleeding due to bed sore formation. A small percentage of these tumors can become cancerous or malignant and start spreading to other parts of the body. These tumors are very vascular in nature, containing large pools of blood in most of the areas.
That is why the surgery of such tumors have a very high risk of uncontrollable bleeding. Proximity to adjacent vital organs and the need for a huge area to cover the defect after surgery makes it even more challenging. These types of surgeries require orchestrated teamwork with complex preoperative, intraoperative, and postoperative management strategies involving multi-disciplinary approach. In this case, as the tumor was non-cancerous, the patient is disease free now and will have a good quality long-term survival.”
Mahipal Singh Bhanot, Business Head, Fortis Hospital Gurugram said, "This case was particularly challenging due to the tumor's extensive size and weight. Nonetheless, our multidisciplinary team, led by Dr. Niranjan Naik, handled it with exceptional skill. I am deeply grateful to everyone involved, including the Surgical Oncology, Interventional Radiology, Plastic Surgery, Anesthesia, OT staff, ICU, nursing, Nuclear Medicine, Radiology, Pathology, and Blood Bank services. Their collaborative efforts were crucial to the successful outcome of this complex case. Having such comprehensive, coordinated teams under one roof is crucial for successfully managing complex medical situations.”
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