Tanzanian man undergoes surgery for tumours in liver, rectum

A 32-year-old Tanzanian man received a new lease of life after undergoing a rare surgery for removal of two large tumours in his liver and rectal areas at a city hospital, doctors today said.
Omar Salim underwent the surgery at the Sir Ganga Ram Hospital (SGRH) on January 31, which lasted for seven hours. He was discharged today.
"He came to us last October, with complaints of a large mass in abdomen and abdominal pain for a year. A previous attempt at surgery in his country had failed in view of the extent of the disease," the hospital said in a statement.

He was initially evaluated with a CT scan of the abdomen which revealed that there was a large mass in relation to the rectum with compression of the urinary bladder and extending to the anterior abdominal wall up to the level of the umbilicus, it said.
"There was another large mass in the left lobe of liver occupying nearly the whole of the left upper abdomen. Biopsy revealed a diagnosis of rectal GIST (Gastro Intestinal Stromal Tumour)," the statement said.
The liver tumour measured 15 x 14 cm and weighed 1.2 kg, while the rectal tumour was 24 x 13 cm in size and weighed 1.9 kg. Despite the extent of the tumour and surgery, the patient did not require any blood transfusion during the operation, the hospital said.

Vivek Mangla, Consultant Gastrointestinal and Hepatobiliary Surgeon at the SGRH, who led the surgery team, said, "There were many challenges in the case. Firstly, this patient had two large tumours, one in the liver requiring a major liver resection, and the other in the rectum, and simultaneous surgery for complete removal of both these tumours in one go was deemed the best treatment option."

Sharing the challenge involved, he said, there was very limited working space as most of the space was occupied by the tumour.
"Presence of vital structures in the area, including the urinary bladder and ureters, and nerves supplying the muscles which work to ensure proper urinary function, increased the complexity of the operation," he said.

"To the best of our knowledge, this is the largest reported rectal GIST, and also the first report of a simultaneous resection for such a large rectal GIST with a solitary large liver lesion," he added.