Surgery saves 3-year-old with huge tumor intruding into his heart

The complex operation took more than five hours and the boy’s heart had stopped beating for 20 hours.
Ti Gong

A 3-year-old boy has been released from Xinhua Hospital after doctors there cooperated to remove a huge renal tumor and a blood clot that had permeated into his heart.

In a case rarely seen in either China or abroad, the treatment needed the cooperation of highly skilled doctors of several departments, the hospital said on Tuesday.

According to the hospital, the parents of a boy surnamed Zhang touched his belly and accidentally found a big lump on the left side on April 15. They measured it and found it was 12 centimeters in diameter.

One week later, the frightened family visited Xinhua Hospital, whose pediatric department is renowned, to see Doctor Wu Yeming, a professor for pediatric surgery. 

The doctor found the boy had a huge tumor in his left kidney, which not only pressed other organs to the right side of his belly, but also intruded upwards into his chest.

The renal tumor cells had made their way into the vein vessel and formed a tumor embolus there, said Wu. He added that the tumor cells continued growing outside of the vein and crossed over the whole abdominal cavity into the postcava of the boy’s right side.

“The postcava connects with the right atrium and the tumor embolus grew into the heart,” said Wu. “What’s worse, they were still expanding.”

It was a rare case as only 7 to 9 percent of a renal tumor would develop into intravenous tumor embolus and only 0.3 to 1 percent of the tumor embolus would expand into the right atrium.

A multidisciplinary team was formed with doctors from pediatric surgery, pediatric hematology, radiotherapy, pathology, medical imaging, nuclear medicine and ultrasound.

The experts all agreed to carry out the surgery as the young patient might die from abnormal heartbeat, pulmonary embolism or cerebral embolism if the tumor embolus continued growing.

Though chemotherapy did not make the tumor smaller, it successfully stopped it from growing and reduced its blood supply, creating suitable conditions for surgery.

The complex operation began on August 10. It took more than five hours and the boy’s heart had stopped beating for 20 hours during the process.

He recovered well and has been released from the hospital, but will now need to go through therapy and radiotherapy treatment.

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