A team headed by Surgical Oncologist, Dr Tanveer Abdul Majeed, Urologist Dr Santosh Palkar and Anaesthetist Dr Shilpa Deshmukh recently performed a successful 9-hour complicated surgery to extract 11 kg mass tumour from a 55-year-old woman’s abdomen.
The procedure was performed during these unprecedented times at Zen Multispecialty Hospital Chembur. The patient was a housewife hailing from Chembur and had generalized abdominal distension which was no big deal a few months ago. However, things turned awry when she noticed that her abdomen was growing day by day causing her a sensation of being bloated and difficulty in breathing.
In June, she consulted a local doctor who did an ultrasound and CT scan that confirmed the presence of a mass (tumour) in her abdomen. Due to COVID19 lockdown and fear of contracting coronavirus, she deferred any further medical advice. Moreover, she did not receive any medications. Over the period of waiting her abdominal distension progressed and made her more breathless. Since it was a very large tumour it made her look obese.
Sharing more information, Dr Majeed, a Surgical Oncologist highlighted, “On evaluation at admission on September 8, 2020, she weighed about 80 kilos, was diabetic and hypertensive. A Contrast CT scan abdomen with vascular reconstruction performed revealed the presence of a large tumour in the abdomen completely filling the right half of the abdomen and extending to the left side displacing the right kidney, duodenum, small intestine and colon to the left side completely so also displacing the Inferior Vena Cava (Major blood vessel) to the left with 270-degree contact with IVC, Aorta, and Right external iliac vessel, It was also splaying the portal vein. It had also displaced the right lobe of the liver to the left and anteriorly. Normally tumours arising on the posterior part of the kidney tends to push anteriorly but it was a large tumour pushing the right kidney on the left side and the whole cavity was occupied by the tumour.”
A clinical diagnosis of Retroperitoneal Liposarcoma was made based on imaging which showed its characteristic nature, Liposarcoma is a rare cancer of connective tissues that resemble fat cells under a microscope. It can occur in almost any part of the body, but more than half of liposarcoma cases involve the thigh, and up to a third involve the abdominal cavity. The patient was scheduled to undergo Exploratory Laparotomy with Intra perinephric Resection of Right Retroperitoneal Sarcoma sos Right Nephrectomy and Vascular replacement of Inferior Vena Cava.
Dr Majeed added, “After opening the abdomen a very large tumour displacing all previously mentioned structures to the left completely. An 11 kg tumour of size 55 cm x40 x 35 was successfully removed. The surgery lasted for gruelling 9 hours and there was 1000 ml blood loss. The patient is in the hospital and doing very well. She is started on oral liquid and tolerating it well so also, she is able to breathe freely. She will be advised to follow up after 3 months of discharge.
“Our world turned upside down when I felt bloated, the stomach appeared bigger and I weighed 80 kgs. We delayed treatment due to the pandemic. But I am fortunate to get operated at Zen Hospital and thank doctors for saving my life. After tumour extraction, I feel lighter now and can eat and breathe properly, and have resumed to normal life,” concluded the patient.
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