By Nicholas Rondinone
If surgeons had waited any longer, a Connecticut woman’s 132-pound tumour would have killed her. But the doctors involved said the surgery earlier this year at Danbury Hospital was a success and the patient has her life back.
The 38-year-old woman, not identified by the hospital, had experienced rapid weight gain last November, at times as much as 10 pounds a week. She saw her doctors, but her size kept increasing. When she met with a gynecologist, a CT scan revealed the massive tumor some 3 feet in diameter.
“It’s exceedingly rare…a tumor of this size, one of this magnitude,” said Dr. Vaagn Andikyan, a certified gynecologic oncologist who led the 25-member medical team at Danbury Hospital. “We are talking about a tumour growing rapidly – in a two-month period.”
When Andikyan first saw the patient earlier this year, he could see her anguish. She was in a wheelchair, the tumour’s size — coupled with intense leg swelling — made it impossible for her to walk.
He said it was not so much that she delayed seeing doctors, but that the growth of the tumour was just so fast that it was able to reach that size.
Though the tumour was benign, it was stressing all her major organs, and putting pressure on her digestive track, preventing her from eating. The patient, Andikyan said, was malnourished and facing certain death if they did not intervene.
“Another week or two, this patient may not have made it if we did not operate,” Andikyan said.
This week, officials from Danbury Hospital announced the tedious Valentine’s Day surgery to remove the tumour was a success by all measures. The patient, after two weeks of convalescing at the hospital returned home, lighter, healthier and more mobile. Her total weight loss was in the range of 185 pounds, Andikyan said.
Not long after the woman first visited Andikyan’s office, the doctor set to work quickly pulling together a skilled team of oncologists, plastic surgeons, gynecologists and anesthesiologists.
From there, the doctors spent two weeks planning for this surgery, which is extraordinary for even the most seasoned hands. Andikyan said for most, a surgery of this complexity happens once in a career. And the life-threatening risks were apparent to all those involved.
“There was a very good chance the patient could’ve have [died] in the procedure,” Andikyan said. “We talked about it with her. If we didn’t do the surgery, the patient would succumb to her disease.”
Officials from Danbury Hospital said they had to map out many of the unknowns and potential hurdles of removing a tumor of this size.
Typically, this type of tumours is slow growing and can get to the size of 10 to 20 pounds, Andikyan said. Media reports show this may not be the largest ovarian tumor ever removed — in the early 1990s, doctors in California removed a gargantuan 303-pound tumour, as reported by a gynecologic oncology journal.
With the mass sitting on major blood vessels, the Danbury Hospital team sought the expertise of cardiologists with the aim of a safe surgery. Preparations were made to the operating room to accommodate the surgeons to work on the massive tumour, and those specializing in recovery were brought in to plan for post-operative care.
Andikyan and his team removed the tumour in a single five-hour operation, and then a plastic surgeon, Dr. David Goldenberg, cut away and mended skin badly stretched by the massive growth.
“I’m so proud of Dr. Andikyan for his leadership and our entire team for having the courage to tackle this extraordinarily complex case. We were all determined to help our patient, even though this was the first time a case like this come to Danbury Hospital,” said Dr. Linus T. Chuang, chairman of Obstetrics and Gynecology for Western Connecticut Health Network, who also serves as the Fred and Irma Bering Endowed Chair in Minimally Invasive Surgery.
Due to the unique circumstances of the tumor — its quick growth and the size — prompted doctors to probe deeper. Andikyan said they are doing intensive genetic testing at Danbury Hospital on the tumor to determine what may have caused it to grow so fast and so large.
They plan to publish the case in a peer-reviewed journal to inform other doctors across the world on the techniques they used to save this patient and return her to a healthy life.
With the tumor out and the recovery moving along with exemplary results, Andikyan said the woman has her life back.
“She is back to her normal life,” he said. “She’s back to work. She is a superstar.”