Aditya Birla Hospital Successfully Removes A Rare 11.2kg Ovarian Malignant Mass From A 22 Year Old Girl, Preserving Her Chance To Become A Mother
18th January 2022: Aditya Birla Memorial Hospital Pune’s 1st JCI and NABH accredited hospital along with other accreditations including ISO 22000:2005 & HACCP, CAP (USA), and NABL, successfully removed a huge cancerous mass of 11.2 kg from a young 22 years old unmarried girl’s ovaries, preserving her fertility and chance of becoming a mother.
Ankita (name changed), a young 22 – year – old unmarried girl belonging to a military family from Pune, was referred to a general physician in her Lohegaon area as her parents felt she was putting on too much weight sitting at home during the lockdown. On investigation, the doctor suggested sonography to rule out any doubts. Her Sonography revealed a huge 45 cm ovarian mass. She was immediately referred to Dr. Madhulika Singh, Gynaecologist, Aditya Birla Memorial Hospital. Once Dr. Madhulika Singh examined her, she asked Ankita
to undergo a CT Scan along with all necessary Blood test.
“The mass was so huge that the upper border of the mass was touching the border of patients breast”, revealed Dr. Madhulika Singh. She doubted that the mass was not benign and hence immediately referred the patient to Gynec Onco Surgeon Dr. Nikhil S. Parwate.
“The case was very complicated as the girl was only 22 years of age and was unmarried. I met her family and explained to them that surgery was necessary. There were two outcomes of the surgery, one where the mass is benign and will be removed without any complication. The second result was if the mass was malignant. In this case, we would have to determine what stage of cancer it is and accordingly, we can decide whether her fertility could be retained or not”, shared Dr. Nikhil S. Parwate. “In general situation, upto Stage 1A – Grade 2 cancer, you can preserve the fertility”, he further added.
The family and the patient both had to undergo multiple counselling sessions, various consents had to be taken before the surgery was performed.
“The case was very tricky and rare. Our first major challenge was to remove the mass in its entirety. The mass cannot be ruptured while being removed as it would spread the cancer all over the abdomen leading to upstaging of cancer and subsequent mortality. Hence it was very challenging to remove this mass which was 11.2 kgs. in weight without rupturing it.
Once it was removed the mass was given as it is to the pathologist, called as frozen section, to immediately diagnose and advise whether the mass was benign or malignant for further course of surgery”, shared Dr. Nikhil S. Parwate.
The pathologists revealed that there were areas of micro-invasive cancer in the mass, hence her cancer was diagnosed as Stage 1A of cancer. On understanding the situation, the oncosurgeon immediately called the medical oncologist who was aware of the entire situation and on discussion, it was jointly decided that the fertility can be maintained.
“We did a Fertility Sparing Onco Surgery immediately where the Uterus & the other ovary is retained while we removed the path of the spread and the tissues surrounding the uterus & ovary. The surgery was successful with the help of the entire team including the proper general anaesthesia given by Dr. Ranjeet and the meticulous reporting at frozen & final histopathology by Dr. Seema Sinha ”, shared Dr. Nikhil S. Parwate.
The complicated surgery went on for three hours and fifteen minutes where no blood transfusion was needed and no ICU stay. The patient was discharged on 3rd post-operative day.
“What Ankita had is an Epithelial ovarian tumor which is generally seen in women of 45 years of age and above. If seen in younger patients, it’s hereditary. Hence we will be investigating her mother and her family tree to know the cause. Ankita has to go through a follow-up plan where she needs to visit us every 4 months and we will do sonography, blood tests, and tumour marker to monitor her health. Ankita is absolutely normal. However we
will continue strict monitoring till she gets married, conceive normally and has a baby in her hand”, concluded Dr. Nikhil S. Parwate.
“We are thankful to Aditya Birla Hospital & all their doctors especially Dr. Nikhil S. Parwate for saving our daughter’s life and working hard to preserve her fertility”, shared the father of Ankita. “We were surprised when Ankita’s condition was diagnosed and was unable to believe that the situation was so complicated, as Ankita participated in a Kathak competition just two months back and had no complaints”, he further added.
“I am really happy that we could save Ankita and preserve her chances of becoming a mother. It was possible only because of the expertise of our doctors and the availability of all facilities under one roof that we could ensure complete cure in one surgery. Our commitment with Ankita will get done once she is holding her own baby in her hands”, shared Ms. Rekha Dubey, CEO, Aditya Birla Hospital.
