54-kg ovarian tumour, half the bodyweight of patient, removed at Delhi hospital

A 54-kg tumour, which was half the bodyweight of the patient, has been removed from her ovary at a city hospital here, with the doctors claiming it to be the largest of its kind to be operated in the world.

The 52-year-old New Delhi resident was gaining weight for the last few months and weighed 106 kg.

She recently started having difficulty in breathing, acute pain in her lower abdomen and consequently problem in walking and sleeping, Dr Arun Prasad, senior consultant, Surgical Gastroenterology and Bariatric Surgery at Indraprastha Apollo Hospitals said.

With rapid weight gain and increasing complications, the family consulted a local surgeon, who then referred the patient to the hospital.

"Upon investigation, it was revealed that the woman had a giant, progressively expanding tumour in her ovary and this was putting pressure on her intestine (intestinal adhesions) causing acute stomach ache and inability to digest food.

"Additionally, her haemoglobin level dropped to six, causing severe anaemia," Dr Prasad said.

In a three-and-half hour surgery on August 18, a team of surgeons extracted the 54-kg tumour from the ovary.

Elaborating on the case, Dr Prasad said, "In over 30 years of my experience as a surgeon I have never come across a case where the tumour weighed almost half the person's body weight. Previously, the largest case was in 2017 from Coimbatore where a lady was operated for a 34-kg tumour in her ovary."

"Extraction of a 54-kg tumour was a challenge for the team. More so because the patient had exceptionally low haemoglobin and had to undergo in total six units of blood transfusion before, during and after the procedure," he said.

This procedure was a perfect example of how important it is to understand the traditional methods of surgery while evolving with new minimal access procedures, the doctor said.

"Here, there was no space in the abdomen for insertion of equipment via laparoscopy or robot-assisted methods, hence we had to resort to traditional methods of surgery.

"With the combined effort of experts from the gastroenterology, gynaecology and anesthesiology teams, the extraction was done successfully," Dr Prasad explained.

A key surgeon in the case Dr Abhishek Tewari said the patient was admitted with complaints of stomach ache, breathing stress and obvious weight gain.

She was advised immediate surgery else the tumour would have grown exponentially and caused pressure on other organs leading to possible organ failure.

"Fortunately, the tumour was benign and the patient had no co-morbidities, which enabled a faster recovery. Post-surgery her weight dropped to 56 kg," Dr Tewari said.

Dr Geeta Chadha, senior consultant, Gynecology and Obstetrics at the hospital said there is no proven reason for the emergence of a tumour in the ovary, but it can happen during the formation of the cells in a human body.

As the first-ever case of a 54 kg tumour in the ovary, this was a challenging procedure. Due to the giant tumour, the intestinal tract was compressed and flattened which was putting pressure on the gut leading to a risk of rupture in the ovary, Dr Chadha said.

"The surgery had to be done with utmost precision, keeping in mind seamless extraction of the tumour and simultaneously ensuring no harm is caused to the ovary or the gut. Post-surgery the patient showed tremendous recovery and is set to be discharged on Saturday evening," she said.