Rohit Shishodia

In a rare case, doctors at Delhi’s Sir Ganga Ram Hospital (SGRH) managed to remove tumours from an 8-year-old boy and his 15-year-old sister's adrenal glands after carrying out complex surgeries.

Manan and his sister Disha Joshi recently presented to the doctors of SGRH with very high blood pressure to the tune of 200/120 mm Hg. They were also suffering from various complications including seizures.

Manan was found to have a large tumour of the size of 4.5 cm in the left Adrenal Gland. Surprisingly his sister Disha was also found to have two tumours, one in each adrenal gland, the larger one in the right adrenal gland measuring 5.5 cms and another smaller one in the left adrenal gland measuring 2.5 cms.

Dr Ashwin Mallya, Urologist and Robotic Surgeon, SGRH, who operated on both the patients, said, “The initial challenge for us was to stabilise the blood pressure of the siblings before planning this complex surgery. We planned to remove the tumours and preserve the normal part of the adrenal gland because they are vital organs of the body as they produce steroids and maintain blood pressure. We accomplished this by using minimally invasive surgery through keyhole incisions.”

Dr Ajay Sharma, Chairperson, Urologist and Robotic Surgeon, SGRH, “The tumours of adrenal glands are very challenging to operate because of their location in the body. These small, triangular-shaped glands are located on top of both kidneys. They are also very close to the major blood vessels and during operation, there are chances of life-threatening fluctuation in blood pressure and heart rate.”

According to the hospital, Manan was first taken for laparoscopic surgery, for left adrenal tumour removal. His tumour was removed and the surgery took two hours with 50 ml blood loss.

After Manan’s surgery, Disha was operated on using robotic technology. Her right adrenal gland along with a 5.5 cm-sized tumour was removed completely. The tumour in the left adrenal gland measuring 2.5 cms was removed sparing as much of the normal adrenal as possible. Her surgery took 3.5 hours.

Biopsy reports of the tumours revealed pheochromocytoma (a rare adrenal tumour).

Genetic studies of the siblings have revealed a rare familial tumour syndrome called VHL syndrome. This syndrome causes tumours all over the body.

Both siblings have recovered and have resumed schooling within 2 weeks of surgery.