A tumor weighing 8 kg, drooping from the right side of a 31-year-old man′s face, was a source of consistent misery for him since childhood. The Odisha resident suffered from a benign tumor of peripheral nerves, rare condition called plexiform neurofibroma.

He had visited several hospitals earlier for partial resection of the tumor. Surgery was attempted at a hospital in Odisha, but it had to be abandoned because of uncontrolled bleeding.

The patient then came to Bengaluru and visited Aster CMI Hospital for treatment, supported by a crowdsourcing effort from Newslions Media Network Pvt Ltd and Milaap. He was subjected to 16 surgical procedures over a period of 6 months by a team of doctors that included the departments of neurosurgery, plastic surgery, oncology, ENT, neuro-anesthesia and ophthalmology.

The tumor covered the right side of his face, head, and neck, and infiltrated into the right orbit. It had engulfed the right eye which made the surgical removal risky.

Dr. Ravi Gopal Varma, Lead Consultant, Neurosurgery and Chief of Neurosciences, said that the CT scan revealed that his facial bones were destroyed by the tumor. Dr. Varma stated that such complicated cases usually require different treatment modalities and a multi-disciplinary approach. The tumor receives blood supply from different blood vessels, thus the tumor grows in size. He said that if they would have removed the tumor as is, it would have caused massive bleeding. Therefore, they blocked the blood supply to the tumor so the patient had less bleeding.

Despite this, he lost a fair amount of blood. Forty litres of fluids, blood and blood components were transfused during the surgery. The tumor was also affecting his mouth opening. Hence, it was difficult to get his breathing tube into his trachea for the first surgery.

Dr. Sathish M S Vasishta, consultant, Craniomaxillofacial Surgery, stated that with the help of CT scans data, a 3D printed skull model of the patient’s face was developed to assess the extent of the tumor and devisean excision plan and reconstruction.

Before the surgery, he weighed 58 kgs and after that, he weighed 44 kg. Once the tumor was removed, he was taken for reconstruction surgery after 48 hours.

Dr. Madhusudan G, Lead and Senior Consultant, Plastic Surgery, said that most of his facial skin had to be removed which led to a large composite skin and soft tissue defect over the right side of the face. The reconstruction surgery was accomplished in two stages using three flaps skin and muscles of both thighs as well as right forearm.

The patient was successfully discharged, is doing well and has returned to his hometown.

Source: The New Indian Express