- The patient had been suffering from the tumor since 2019 but no doctor was willing to operate
- This is a classic case of a patient with little time to live and clinical excellence is proven again
Ahmedabad: Dated: 11th September 2023: In a rare case of a 24-yearS-old with a rare type of tumor termed aspheochromocytoma, usually represented by severely elevated blood pressure, a sense of losing one’s life mimicking the symptoms of a cardiac arrest like shortage of breath, severe sweating, and rapid heartbeat, the oncology team at Marengo CIMS Hospital conducted yet another exemplary treatment surgery to save the life of the patient. The surgery was conducted by Dr Nitin Singhal, Clinical Director, Marengo CIMS Hospital, and his team.
The 24-year-old boy from Mozambique was presented to Marengo CIMS Hospital with uncontrolled hypertension, pulse rate, and severe headache. The patient had been detected with an adrenal mass on the right side in the year 2019. This mass had been sitting in his body behind the area where the kidney is located over the past 3 to 4 years, the size of which kept on Increasing. COVID had pushed his treatment to a critical time after which doctors in Mozambique were unable to treat him due to the criticality of his condition and lack of infrastructure and clinical excellence.
With the inordinate delay,the patient’s condition became so critical that it rendered the option of surgical intervention very difficult, along with the uncontrolled blood pressure and very high pulse because of which he was refused surgery at multiple places.
When he finally came to Marengo CIMS Hospital, he was re-evaluated to assess the complexity of his condition and the mass had more than doubled the size in a few months and had become even more challenging for the team of doctors. The tumor was stuck on the right kidney and liver and supplied by multiple vessels from the inferior vena cava(the main vessels that carry body blood into the heart) and head multiple neo vascularity from renal vessels and lumbar vessels.Removing a major mass that was the size of a small football in such a young boy and saving his kidney without damaging the liver with the altered blood pressure which was very high (240/ 140 mm Hg) was indeed a herculean task.
Usually, such patients are put on 7 to 10 days of alpha-blocker drugs to control the blood pressure, but in this case, due to compressive symptoms in the kidney and with the scan showing recent bleeding in the mass the case needed to be taken on an urgent basis. The patient had almost a mere 1 – 2 days to be saved from any fatality.
Dr Nitin Singhal, Clinical Director says, “We are glad we could remove the mass enblock without major blood loss and could save the kidney and liver also and the patient is doing fine now. This mass is a giant pheochromocytoma by definition of the size of 18 x 15 x 13 cm and is probably one of the biggest adrenal pheochromocytomas that have been resected as per the best of our knowledge.We successfully achieved the task with wonderful teamwork with my Anesthetists Dr Deepak and Dr Mayank, Dr Swati Uro-surgeon and Dr Bhagyesh ( intensivist) and,Dr Vivek Patel ( endocrinologist).”
Dr Raajiv Singhal, Managing Director and Group CEO, Marengo Asia Hospitals says, “Marengo CIMS Hospital remains steadfast in its dedication to delivering the highest standards of clinical excellence to save an increasing number of lives. Through this patient’s case, we are further emphasizing our dedication to MVT, or Medical Value Travel, which encompasses not only medical care but also the idea of creating accessible, top-quality healthcare and cost-effective treatment options through clinical corridors. Our ongoing efforts are committed to meeting the challenges of treating patients and igniting hope for those who travel across borders to seek medical assistance from our institution.”
Pheochromocytomas are rare, occurring in about 2 to 8 out of every one million people. Approximately 10% of patients are found to have pheochromocytomas in both adrenal glands, which is most commonly seen in younger patients with pheochromocytoma-related genetic syndromes.