Doctors at Rajiv Gandhi Government General Hospital (GH) have removed a 5.2-kg tumour from the liver of a 30-year-old woman.
Zaris, a resident of Perungalathur, approached doctors at the surgical gastroenterology department of GH in May this year, with complaints of pain and swelling in the abdomen. A CT Scan revealed that she had a 37-cm lesion arising from the right lobe of the liver, said S.M. Chandramohan, head of the department.
“We initially attempted to reduce the size of the tumour by embolisation – blocking blood supply to the tumour – but we could not, as numerous blood vessels were supplying blood to it,” he told reporters on Monday.
The doctors looked for literature on similar cases and came across a publication by doctors in Japan. “A team there had used a chemotherapeutic agent – Sorafenib – used for treating liver cancer to reduce the size of a tumour. We consulted our oncologists and haematologists and gave her the drug for a month starting July 24. The size of the tumour reduced by 44 per cent but we could not continue the drug due to side effects. The patient had problems of hypertension, skin rashes, vomiting and respiratory distress,” he said.
Once the drug was stopped, the tumour regained its growth.
With no other treatment options, doctors decided to surgically remove the tumour. A team of 11 doctors – drawn from the departments of surgical gastroenterology, cardiothoracic surgery, anaesthesiology, radiology and haematology – planned the surgery.
“We decided to have a combined thoracic and abdominal approach for the removal of the tumour to have control over the major vessels coursing through the chest and abdomen. One litre of blood flows through the liver hepatic artery in a minute and reaches organs such as the spleen, small and large intestines and so, we cannot stop the blood flow,” he explained.
The patient had fluctuations in blood pressure during the surgery and lost five litres of blood. “The tumour weighing 5.2 kg was removed. It was 41 cm long. The right lobe of the liver was removed but the organ is fast at regeneration. About 32 units of blood and blood products were transfused during the surgery,” he said.
“We did a thorough search for larger tumours. This could be one of the largest tumours to be removed by a new approach,” Dr. Chandramohan said.
Ms. Zaris said she was diagnosed with a small-sized tumour in 2010. Married to an autorickshaw driver, she had three miscarriages, which doctors say could be due to the tumour. Her brother Sadiq Basha, who had to quit his job to take care of her, said she was recovering after the surgery. Zaris was discharged on Monday.
Anand Prathap, resident medical officer of GH, said the surgery was performed under the Chief Minister’s comprehensive health insurance scheme. N. Nagarajan, professor of cardiothoracic surgery also participated.