In an unimaginable incident, a group of doctors successfully removed a 9.1kg tumour from the abdomen of a 55-year-old African woman. The enormous tumour was almost the size of a football that had been causing immense abdominal pain for the last 6 to 7 months. The patient consulted multiple hospitals in Africa and India, but they all refused to conduct surgery because of the huge size of the tumour and lack of clarity about its origin.?
The surgery was conducted at the Fortis Hospital Gurugram, under the team of Dr Amit Javed, director of gastrointestinal oncology, and other team members. According to the prior inspections, it was revealed that the woman was undergoing severe abdominal pain due to the massive colossal tumour that was deflating other body organs including the urinary tract and kidneys.?
Despite the surgery¡¯s complexity, the team of doctors chose to go ahead with the three-hour surgery which turned out to be successful. Finally, the patient was discharged just four days later in stable condition.?
The case may seem unusual due to the size of the tumour, and you might be wondering, ¡°Could this happen to me? Or ¡°How would I know if I have a tumour?¡± Well, if you are asking yourself these questions, then it's important to know that early detection is key. To dive deeper into the nitty-gritty of tumours, we had a Q&A session with? Dr Bharath G, Consultant- Surgical Oncology, Fortis Hospital, Nagarbhavi and Dr Monika Pansari, Senior Consultant ¨C Surgical Oncology, Fortis Hospital, Bannerghatta Road, Bangalore
Q. This is one of the particular cases, so what makes it unique in terms of its complexity and rarity for doctors?
This case is unique due to the tumour's massive size (9kg) and rarity. Gastrointestinal stromal tumours (GISTs) of this magnitude are extremely uncommon. According to Dr Bharath, ¡°The complexity lies in removing the tumour while preserving surrounding organs and ensuring minimal blood loss." Only a few similar cases have been reported worldwide.
Q. Is this type of tumour more commonly found in certain populations, or is it truly rare across the board?
A. Gastrointestinal stromal tumours (GISTs) are rare, affecting approximately 1 in 100,000 people. They can occur in anyone but are more common in middle-aged and older adults.?
¡°There's no specific population predisposition, but some genetic syndromes increase the risk. This case highlights the importance of awareness and prompt medical attention,¡± noted Dr Bharath.?
Q. How long does it typically take for a patient to return to normal activities after such a major procedure?
A. Certain factors influence the recovery including tumour size, surgical complexity, overall health, and post-operative care. While explaining this question in detail, Dr Pansari said, ¡°Typically, patients take 3-4 weeks to recover from such a major procedure. However, full recovery may take 2-3 months. Patients require ongoing monitoring to ensure no complications or recurrence."
Q. But the question arises, could this case serve as a reference for treating similar tumours in the future?
A. This case will serve as a valuable reference for treating similar tumours. The surgical approach, techniques, and post-operative care can inform future management strategies.?
Moreover, documenting such rare cases contributes to the medical community's understanding of GISTs and helps improve treatment outcomes for patients with similar conditions, noted Dr Bharat.?
Q. How do we understand the difference between gastrointestinal stromal tumours and other types of abdominal tumours?
A. Gastrointestinal stromal tumours (GISTs) differ from other abdominal tumours in their origin (connective tissue), growth pattern, and genetic characteristics. Unlike carcinomas, GISTs arise from interstitial cells of Cajal and have distinct molecular markers. Accurate diagnosis is crucial for targeted treatment.?
Q. What other organs could have been affected if the tumour had continued to grow or spread?
A. Seeing the everyday and unique cases of tumours in hospital, Dr Pansari pointed out, ¡°If the condition is left unchecked, the tumour could have affected nearby organs, such as the liver, stomach, small intestine, and kidneys. Compression or invasion of these organs could lead to severe complications, including bowel obstruction, bleeding, or organ failure.¡±
Q. How does a tumour of this nature grow, and what could have happened if the condition was left untreated?
A. GISTs grow from abnormal cells in the digestive tract's connective tissue. If untreated, they can grow rapidly, invade surrounding tissues, and potentially metastasize. Untreated GISTs can lead to life-threatening complications, including bowel obstruction, perforation, or bleeding. Prompt surgical removal is often the most effective treatment.