Successful surgery of malignant tumour within brain: A Case Study
Dr. Manish Kumar MBBS, DNB (Neurosurgery)
Surgical Case Reports 2017 © The Park Group of Hospitals. 2017
Brain cancer is the medical condition of presence of malignant tumour within brain. These malignant tumours grow quickly within the particular part of the body occupying the space of healthy cells and tissues. The brain cancer can occur in adults as well as children. The nature and the treatment of the formed tumour vary in adults and children. The chances of the recovery of the patients are dependent on many factors such as age, size, type and the place in the Central Nervous System. The patient was brought to the Park Hospital, Faridabad in an unconscious state with inability to talk and difficulty in the movement of the right side of the body. The initial investigations and scans of the patient showed the presence of tumour on the left side of the brain close to the Primary Motor Cortex (area for speech and right-side limbs movement) along with the commissural fibre (fibres connecting the two sides of the Brain). After explaining the pros- cons of the surgery to the attendants, the surgery was conducted by the team of experts under the supervision of Dr. Manish Kumar.
Brain Cancer is one of the malignant tumours that occurs in a part of the brain and spreads across replacing the healthy cells of the brain. A tumour is considered to be the cancer after complete medical investigation of the same. The medical investigation to detect the presence of tumour includes Neurological exam / Tumour marker test / Gene testing / MRI / CT scan / PET scan / SPECT scan. Once the tumour has been diagnosed, the medical professionals perform a biopsy of the tumour to verify if its cancer or not. The type of biopsy performed usually differs according to position of the tumour. In case, the tumour is deep in the brain and is difficult to remove or operate, Stereotactic Biopsy is performed wherein a biopsy needle is inserted through the hole in the brain made with small incision to remove the cells for the pathology tests and study. However, in case the tumour is removable through surgery, craniotomy is performed to remove a part of the tumour for study.
The patient was admitted to the Park Hospital Faridabad on 2nd June 2017 in an unconscious state. The patient was having difficulty in speech and the movement of the right side of the body. The patient and the family noticed the symptoms around 15 days ago when there was noticeable difficulty in walking. Gradually, the pain and the disrupted movement increased with the patient being completely unresponsive on 29th May 2017. The MRI Scan of the brain noticed a tumour on the left side of the brain close to the Primary Motor Cortex (area for speech and right-side limbs movement) along with the commissural fibre (fibres connecting the two sides of the Brain). Dr. Manish Kumar said that in such conditions, there is a high risk of permanent speech loss and weak limbs and there is risk to life also, if surgery is not done in time.
After investigation and complete examination, nature of the disease and the need for the surgical intervention, along with its limitations and possible complications were thoroughly explained to the patient’s relatives since patient was unconscious. Temporary medications were already started by that time. After the consent of the relatives, left frontal craniotomy for the safe excision of the tumour along with biopsy was carried out. Post operation patient improved slowly and became fully conscious and independent. Biopsy proved high grade malignancy of brain tumour.
According to Dr. Manish the patient was in a critical situation when he had arrived. He was running the risk of life. He is back to normal life, after the successful surgery. But the tumour is among the worst type of cancer and requires immediate further treatment by radiation therapy and medicines. Despite of all the treatment, the life expectancy is limited in such cases. But after the present surgery, a good recovery has proved the feasibility of complicated high risk surgeries at the Park Hospital Faridabad.
Post surgery, the patient is very well and is also not having any issues with the speech or any sort of movement. He is eating well and is able to talk properly now as mentioned by the patient himself. He further added to the statement that he was able to work normally the next day of the surgery and hopefully will soon have normal range of speech movement.
The case study is presented with the consent of the patient and his family members.