Was an incredible intervention the one performed in the gynecological surgery department of the Ss Annunziata hospital in Chieti, and performed by the team of professor Alessandro Lucidi. A 75-year-old woman resident in the area had arrived at the hospital emergency room with excruciating pain and an abnormally swollen abdomen.
The discovery of the tumor
The woman was immediately subjected to radiological tests, which revealed an anomalous mass in the large pelvic area. But only when the patient was transferred to the operating room for removal, the surgeons realized the real situation. The tumor formation was enormous, over thirty kilos, which required open surgery, i.e. opening the patient’s abdomen, rather than operating, as usually happens, with laparoscopy, a less invasive modality.
The surgeon’s amazement
“It was an exceptional case – commented Dr. Lucidi, a specialist in oncological surgery with long experience gained in prestigious hospitals such as the Gemelli in Rome – never before seen a mass of such proportions, which made traditional surgery necessary. The dimensions themselves complicated the operation, limiting movement and making it difficult to restore the integrity of the vessels and tissues.”
In addition to removing the mass, the patient’s uterus and ovaries were also removed and samples were sent for the histological examination necessary for staging the tumor.
Exceptional intervention
The operation represents an exceptional case in the clinic led by the professor Marco Liberatiwhich in recent years has become a true excellence in female oncological surgery. Thanks to the system “da Vinci Xi“, a new cutting-edge technology, already over 53 patients have undergone non-invasive operations with minimal incisions which reduce recovery times and the risk of post-operative complications.
Staging
Although the operation performed was a rare one due to the size of the tumor mass, there are still many similar cases, because tumor cells behave very differently from healthy cells. They grow and multiply uncontrollably, without completing their life cycle as and when they should. They thus form a tumor mass which, unlike healthy tissue, grows without limits, without recognizing boundaries around itself. Furthermore, tumor cells can detach and migrate from the initial mass, reaching other parts of the body through the lymphatic system or bloodstream and giving rise to metastases.
Staging is a method to describe in a schematic, rigorous and standardized way how large a tumor is and how much it has spread from the original site. This helps to establish in which phase of this process the tumor is, how large and widespread it is and therefore represents a fundamental aspect that allows the diagnosis to be defined, since both the prognosis of the disease and the most suitable types of treatment can depend on these characteristics. appropriate to administer.
The intervention methods
For example, if the tumor is located in a single location and is small, local treatment such as surgery or radiotherapy can be curative. However, in cases where it is extended to other locations, an intervention at a local level is normally not enough and it may be necessary to resort to systemic treatmentscapable of producing effects throughout the body, such as chemotherapy, hormone therapy or other more recent pharmacological treatments (for example molecular targeted therapies or immunotherapy).
How is the stage of a tumor measured?
Regardless of differences and specificities, almost all staging systems detect:
• The size of the primary tumor;
• Metastatic involvement of the lymph nodes, when tumor cells have migrated to the lymph nodes via the lymphatic system;
• The presence (and number) of distant metastases, i.e. tumor cells that have migrated through the blood from the primary site to other organs.
Record tumor masses
Although the operation performed in Chieti was exceptional, record-breaking tumor masses have been removed worldwide. In 2004, a team of Romanian and American doctors led by professor Ion Lascar removed a 79-kilo mass from a 47-year-old woman. Lucica Bunghez, who had spent many years in bed precisely because of this mass, which was almost double its weight and it covered her back, waist and hips. The cost of the surgery was paid by Discovery Channel in exchange for the film rights.
In 1998, again Professor Lascar, head of the hospital’s plastic surgery department Floreasca of Bucharest successfully removed an even larger mass of approx 90 chili
by an American woman. But, according to the Guinness World Recordsthe largest tumor ever removed weighed 136 chili and it was removed in a patient who fortunately recovered completely.
