21 docs remove complex tumor from teenager's neck

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Surbhi after surgery

A team of 21 doctors at Aster CMI Hospital, Bengaluru, have given a new lease of life to a 15-year-old girl from Gujarat by removing a 3.5 kg crippling tumor from her neck.

The tumor had grown to a football and stuck on her neck. Extending from her neck onto her chest, the benign tumor had affected Surbhi, the patient’s, life for more than a decade.

The girl, who got the disease in her initial childhood, fought a twin battle of disease and poor financial condition. The treatment involved surgeries and injection sclerotherapy which were quite expensive.

Surbhi said that she was unable to go anywhere because of the tumor. She had to drop out of school a year ago due to the immense pain in her neck while doing her homework or an assignment at school.

“Even while stepping out, I had to cover myself and, unlike other girls, I could not wear normal clothes and dresses due to the ailment. I often used to ask my mother, why am I the only one who is suffering and there were several moments when I used to feel hopeless and frustrated,” she said.

Fortunately, hope soon arrived in the form of few well-wishers. The NewsLions agency, helped facilitate the treatment along with Milaap, a fund raiser, which raised over Rs. 70 lakhs through a crowd funding effort to provide her this life-changing surgery involving multiple sittings over one year.

Dr. Chetan Ginigeri, Consultant - Paediatrics and Paediatric Intensive Care, Aster CMI Hospital, said: “There were three tumours present in her throat, intertwined with the nerves of her neck, which made her surgery extremely complicated. Even though we were taking all the necessary precautions, the outcome of her surgery was uncertain to us due to the critical nature of her case.”

“She initially had to undergo intervention radiology that entailed feeding vessel embolization under general anaesthetic. The team of doctors then carried out surgical debulking of the tumour. Following these procedures, flap reconstruction was done for the area affected,” he added.

“At the time of discharge, Surbhi was able to walk and do her routine activities. The wound completely healed and she could eat and drink safely. A tracheostomy tube was fitted in her windpipe for airway protection. She is also undergoing voice training and it is likely to take around three more months for her to completely recover,” said Dr Ginigeri.

Dr. Girish G, Consultant - Surgical Oncology, Aster CMI Hospital, said: “The case had extensive involvement of structures in the neck going to upper torso, both within and out of the thoracic cavity. The case was also immensely critical as the tumour had grown in the neck region where all the essential structures of life are located and hence we had to take extra precautions during the surgery.”

“As expected, she came back with a recurrence in 10 months in the neck which required re-excision. Presently, she is fine, tolerating oral diet with no breathlessness and talking comprehensively. We overcame challenges in treating her successfully through a multi-disciplinary approach.”

Dr. Madhusudan G, Lead and Senior Consultant - Plastic Surgery, Aster CMI Hospital, said: “The complete removal of the tumour posed a challenge of wound cover over the big blood vessels of the neck, exposed to sternum which was as large as 20 x 18cms. In view of such a large size defect, the coverage using adjacent skin flap was not feasible.”

“Hence, a proportionately sized flap was taken from her thigh and was used to cover the wound by microsurgical technique. There was an additional challenge of positioning of the flap and recipient neck blood vessels which was successfully managed using vein grafts. When she came after 10 months she had developed contracture along the neck scar which was also released surgically,” said Dr Madhusudan G.

Dr. Ganeshakrishnan Iyer, Lead Consultant - CTVS Surgery, Aster CMI Hospital, said: “This was a very extensive tumour growing in front and behind the sternum (breast bone). Hence, the difficulty involved in removing the tumour from the front of the chest and then cutting open the breast bone was very challenging as the tumour was also stuck to the chest wall on the inside.”


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