UAE: Doctors remove 4.65kg football-sized tumour from patient's stomach in 6-hour marathon surgery

Surgeons at a private hospital in Abu Dhabi extracted a football-sized cancerous tumour weighing 4.65 kilograms and occupying over 50 per cent of a patient's abdominal cavity. Doctors diagnosed the patient with liposarcoma (a malignant tumour), which can snowball into a large size within a year when left untreated.

Yusuf Miya Ismail Ustad, a 60-year-old Indian national and carpenter by profession, had suffered from mild pain in his abdomen for the past six months. Although a physically active man with two grown-up kids, Ustad had no lifestyle-related issues of diabetes or obesity.

However, having access to healthcare facilities, he decided to get his abdominal pain investigated. On October 23, Ustad consulted doctors at NMC Specialty Hospital in Abu Dhabi. After the initial evaluation, he got referred to a tumour surgeon Dr Balaji Balasubramanian, a surgical oncologist at the same hospital.

Dr Balaji evaluated Ustad for his vague abdomen pain. After a clinical examination, he was found to have a large mass occupying the whole right side of the abdomen. The CT scan confirmed the presence and location of a large tumour. It extended from the undersurface of the liver to the right side of his pelvis. It encased the right kidney, pushing the duodenum (part of the intestine connected to the stomach) and right-side colon (the longest part of the intestine) to the left of the midline. The possibility of liposarcoma, a subtype of soft tissue cancer, was considered. Fortunately, further evaluation did not show any distant metastases (spread of cancer).

A multidisciplinary team, including a surgical gastroenterologist, a urologist, and tumour surgeons, discussed his case, and accordingly, Ustad was counselled for surgery to remove the cancerous tumour.

The family, including his wife and two children, flew down from India to support him, and got admitted to the hospital on November 10 for surgery. The duration until his family arrived, gave the surgical team a reasonable pre-operative planning time.

Dr Nagendranath Chilumukuru, a surgical gastroenterologist at NMC Specialty Hospital and a part of the surgical team, said that the tumour was quite large and closely associated with four essential structures: the colon, duodenum, right kidney, and a major blood vessel called the inferior vena cava.”

In a 6-hour marathon surgery, the tumour was resected intact without leaving any residue after sparing the four vital structures with Dr Balaji leading the team, preserving the kidney from the surgical damage. The tumour weighed 4.65kg, and the patient had minimal blood loss, not requiring any transfusion.

Ustad’s case was again discussed in the multidisciplinary tumour board whilst reviewing various aspects of the literature. It was finally decided to keep him on a close follow-up as there is about a 30 percent chance of the tumour making a comeback. However, his doctors were happy as no adjacent organs were sacrificed, which improved Ustad’s rate of recovery in the absence of any fallout of surgery.

Despite having such a rare and potentially challenging tumour, Ustad’s surgery went on uneventfully, and ICU care postoperatively was also not required. He went home on November 16 and was back to work as per plan at the earliest possible time.

A grateful Ustad sounding happy at the successful surgery, said, “Cancer is treatable and curable, and my family and I are profoundly thankful to the surgical and the nursing teams at the Hospital. After knowing the size of the tumour removed, I truly feel much fitter and healthier.”

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• Abu Dhabi