Doctors at Fortis Hospital, Shalimar Bagh recently removed a gargantuan tumour from the abdomen of a 32-year-old African patient.

It was 36 by 40 cm in size and weighed an astounding 24 kilograms. As the tumour grew in the patient over the last few years, it gradually suppressed major organs, causing severe distress. The patient had sought help from doctors in his home country of Tanzania, but they were unable to operate a tumour of this size. The case was then presented before Dr. Pradeep Jain, who along with his team, was successful in managing this complex case, which had a high-risk rate, requiring precision and intricate skill.

On presentation, the patient was extremely weak. He had a large bulge in his abdomen along with a scar (from a previous surgery which he had undergone in Tanzania). His MRI report confirmed the presence of a large solid cystic tumor in the abdomen.

He was re-evaluated at Fortis Hospital Shalimar Bagh, and the MRI, PET and CT scan confirmed the presence of a large intra-abdominal tumour which was pushing the intestines on one side and compressing the ureters (the tube which brings urine from kidney to urinary bladder).

He was operated on the 31^st May 2019. The tumour was densely adherent to the abdominal wall, urinary bladder and small intestines with large blood vessels surrounding it. Slow and deliberate dissection was performed to remove it. It was extracted along with a segment of the small intestine and part of urinary bladder. The procedure took six hours, during which the patient lost close to 4 litres of blood. To overcome the heavy blood loss, the team was prepared with blood, plasma and platelets. To stop the bleeding, the doctors had to pack the bed of the tumour (which was in the pelvis) with abdominal sponges.

Dr. Pradeep Jain, Director, GI Oncology, Fortis Hospital Shalimar Bagh said, “The patient came to us in a very severe condition. The tumour had been growing in his abdomen for the past 1.5 years and was pushing against the large intestines and was compressing the ureters. It was densely adherent to all organs and had large feeding vessels, making it a highly vascular tumour. The surgery was very difficult because of the tumour’s size. During the operation, there was a chance of massive blood loss which could have been life threatening. There was also a risk of intestinal and urinary leak as the tumour was very close to intestines and urinary bladder. The surgery was successful, and the patient responded very well to the treatment. It is extremely rare to see a tumour of that size. it weighed 24 kilograms, making it life threatening. Mr. Jawe was extremely fortunate to have survived this long without suffering any severe medical condition. While some patients may not have adequate medical facilities in their native countries, it is advisable to get the best treatment at the earliest and not wait for the condition to become this serious.”

Mahipal Singh Bhanot, Facility Director, Fortis Hospital, Shalimar Bagh said, “While we have piloted several complex surgeries in the past, this case was truly rare. When the patient came to us, we were aware of the challenges the case would bring. The patient’s situation was life threatening, however, it was successfully handled. The post-operative period was fraught with complications, but Dr. Pardeep Jain and his team was able to handle them.”

Post-surgery the patient was put onto a ventilator. The abdominal packs were removed 60 hours after the procedure. He came off ventilator support on the fourth day post-surgery. Within 2 weeks of his surgery, he had recovered and is doing well. A histopathology report stated that the patient had a high grade gastrointestinal stromal tumour (GIST). He will be given targeted oral chemotherapy now to ensure full recovery and avoid any re-occurrence.