A city hospital has performed a rare dual surgery on a 29-year-old African woman who was diagnosed with a tumour in the adrenal gland after she got admitted for surgery on a defective heart.

Imange Djema, hailing from Congo, had been referred to Fortis Malar Hospital for treating a condition of Tetralogy of Fallot, or a condition of quadruple defects in the heart characterised by a narrowed blood vessel to the lung, hole in the heart, thickening of the right chamber and the influx of blood from the left and right chambers to the aorta.

A routine CT scan, however, picked up a large tumour in the adrenal gland (a condition known as phaeochromocytoma), and turned the course of treatment on its head. A team led by K.R. Balakrishnan, Director, Cardiac Sciences, realised that they had virtually no clinical parallel in medical literature to fall back on for formulating a treatment plan. The only two cases in literature citing a co-morbid condition of Tetralogy of Fallot and adrenal tumour did not cite simultaneous correction of the two conditions.

Though the patient's tumour was a non-cancerous one, it was causing wild swings in the blood pressure.

“After consultations, we decided to treat both conditions…to remove the adrenal tumour first and address the heart problem a week later,” said Mohan Rao, general surgeon. In some cases, not treating the tumour could prove fatal, Sriram Mahadevan, endocrinologist said.