October 21st 2021
Gurugram: A team of doctors at Fortis Memorial Research Institute successfully removed the world’s largest chest tumour weighing 13.85 kgs from the chest of a 25-year-old male patient.
As per the available medical literature and published papers, the largest chest tumour removed till date, prior to this case, was in Gujarat in 2015 weighing 9.5 kgs, the hospital said in a statement on Thursday.
Patient Devesh Sharma came to Fortis with breathlessness and extreme uneasiness in the chest. He wasn’t able to sleep straight on the bed due to breathing trouble since the last 2-3 months.
An earlier CT scan at another hospital in the city indicated the presence of a massive tumour in the chest. It occupied more than 90 per cent of the chest area, engulfing the heart and displacing both lungs which led to only 10 per cent of the lungs functioning.
In addition, the patient had a very rare blood group, AB negative.
Due to the vast size of the tumour, it could not be removed through minimal invasive surgery. Thus, the Fortis doctors, in a 4-hour long surgery, opened both the sides of the chest and cut the chest bone (sternum) in between.
“In technical terms, we call it clam shell incision. Throughout the procedure, maintaining adequate blood flow was critical. This was a high risk surgery owing to the bulk of the tumour, which had occupied the entire chest making it difficult to operate on multiple vessels as the neck of the tumour couldn’t be controlled and the capsule of the tumour cannot be breached,” said Dr Udgeath Dhir, Director and Head, CTVS, at Fortis, in the statement.
Post the surgery, the patient was shifted to the ICU, and was initially kept on ventilation and later weaned off.
However, the carbon dioxide in his blood started rising owing to which his lungs which had initially contracted started expanding leading to Re-expansion Pulmonary Edema (RPE).
“We tried to manage this conservatively without invasive ventilator support, but after 48 hours had to put him back on ventilator. Considering his condition, we decided to do a tracheostomy, where we created a mini hole in the neck so that we could take out his secretions since he had also developed dense adhesions in his heart,” Dhir said.
“The patient stayed in the ICU for 39 days, post which he was shifted to a room and his tracheostomy was removed. The patient is doing well, and on bare minimal oxygen support. We are happy that he is gradually recovering,” Dhir added.