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Medicine

This Indian man’s record-size brain tumour was so big it ‘sat like a head on top of another head’

‘The sheer size of the tumour was a challenge, and we had to ensure blood pressure was maintained while surgery was on’

PUBLISHED : Friday, 23 February, 2018, 12:30am
UPDATED : Friday, 23 February, 2018, 12:30am

For the past several years, Santlal Pal had been watching the tumour emerge from his skull.

Doctors in India say Pal’s brain tumour grew so big that it weighed nearly four pounds and measured nearly 20cm by 30cm by 30cm, according to local news reports.

It may have been the largest brain tumour in the world. But now it is gone: Doctors successfully removed the mass during an intensive, six-hour operation on Valentine’s Day.

Trimurti Nadkarni, head of the neurosurgery department at Nair Hospital in Mumbai, told the Indian Express that the tumour “sat like a head on top of another head.” Surgeons “had to cut through the bone,” Nadkarni said. “The sheer size of the tumour was a challenge, and we had to ensure blood pressure was maintained while surgery was on.”

More than a week after the surgery, Nadkarni told BBC News that Pal, a 31-year-old shopkeeper in the state of Uttar Pradesh, is “out of danger. Now it’s a matter of recovery.”

The Hindu news site reported that Pal’s brain tumour had been growing for several years – most rapidly in the past year. The mass was clinging to the back of Pal’s head; his skull and hair grew over the top of it. The mass appeared as large or larger than Santlal Pal’s head.

“In a month, it grew over an inch,” his brother Akhilesh Pal told the Indian Express.

Following treatment, including chemotherapy, the mass continued to grow, Akhilesh Pal said. “He would feel a heaviness in his head, which ached constantly, and his vision was blurred,” he told the newspaper.

Pal’s wife, Manju, told the Hindu that the couple consulted several doctors in Uttar Pradesh but were told that the tumour was inoperable.

Doctors said about 10 per cent of the tumour was growing within Pal’s skull, putting pressure on his brain and causing him to lose his eyesight; if not treated successfully, it could have caused neurological damage or paralysis.

Surgeons at Nair Hospital took it on.

“We had to cut open the scalp and remove the tumour,” Nadkarni, the neurosurgeon, told the Hindu. “The part of the tumour within the skull was removed by making an opening in the skull.”

Nadkarni said Pal received 11 units of blood during the operation and that, for three days following the procedure, he had to be on a ventilator to breathe. “Such cases are critical,” the surgeon told the BBC.

Doctors are now waiting to see whether Pal will regain his eyesight. “We are praying that he regains his vision,” Pal’s wife told the Hindu.

Srikant Balasubramaniam, with the neurosurgery department at Nair Hospital, told the Indian Express that the medical centre treats about 500 brain tumours per year, half of which are in advanced stages. “The tumour in Pal’s head grew so much because his surgery was delayed,” he said.