Mumbai: An expert team headed By Dr. Tanveer Abdul Majeed, Surgical Oncologist, Zen Multispecialty Hospital, Chembur, performed a three-hour complicated surgery to extract 4 kgs and a 43 by 20 by 18 cm tumor from a 64-year-old man’s leg amid the Coronavirus pandemic.
Mr. Mahendra Meghani (Name changed) a resident of Khed, Chiplun, who was diabetic and obese, encountered swelling in the left leg, for the last 8 years since 2012 and that made his life miserable. He initially neglected and did not consult a local doctor, but when the swelling began to grow in size and cause discomfort, he consulted a local doctor who advised him to get evaluated but he deferred the evaluation due to COVID – 19 Pandemic. Things turned awry when he developed dull aching pain and redness over the swelling causing noticeable difficulties in his day to day activities and needed assistance for even his routine activities. Subsequently, he was referred to Zen Multispecialty Hospital, Chembur, wherein he got a fresh lease of life.
Dr. Tanveer Abdul Majeed, Surgical Oncologist, Zen Multispecialty Hospital, Chembur, said, “On admission, he complained of discomfort, swelling in the thigh, and pain which was aggravated due to movement. He weighed about 81 kgs and had undergone preoperative biopsy suggestive of Atypical Lipoma, the cause of which is unknown. On examination, there was a huge mass occupying the whole of the front and lateral aspect of left thigh occupying the whole thigh from the hip to the knee joint with dilated veins over it, however, redness and warmth were more pronounced over the lower end swelling just above the knee joint. The mass measured about 43 by 20 by 13 cms and was adherent to muscles of the left thigh. Preoperative MRI revealed swelling as described which was going in between the muscles of the anterior and lateral compartment of the thigh sparing but in close proximity to blood vessels and nerves of the left thigh, showing variegated appearance with vascular enhancement comprising of solid areas suggestive of cancerous change. After preoperative evaluation and optimization on 20th October 2020, he underwent wide excision of Liposarcoma under general anesthesia.
Dr Majeed added, “A lazy S incision over the left thigh was taken, skin flaps were raised with adequate soft tissue cover over the tumor, complete wide excision of the tumor was performed taking care to prevent damage to blood vessels and nerves without compromising adequate oncological clearance. A part of vastus medialis and rectus femoris muscle was sacrificed along with exterior patellar reticulum enbloc all along the knee joint cavity was safeguarded. Since the attachment of vastus intermedius was sacrificed this was followed by musculoplasty to reattach the detached muscle for adequate extensor functioning. The surgery lasted for grueling 3 hours and there was 350 ml blood loss. The patient was subjected to rigorous rehabilitation in the post-operative period with quadriceps and hamstring exercise to prevent muscle wasting and strengthening his knee muscle for early recovery, so as to enable him to start walking in a week's time. He was discharged after 7 days of operation.
“My life was disrupted once there was swelling in the left leg and it kept on increasing. I couldn’t perform day-to-day activities such as walking or even sitting. I was hoping for some miracle to happen and happy that the hospital came to my rescue. I thank the doctors for helping me get back on track. After the tumor extraction, the swelling has disappeared and I will be able to wear a trouser of my actual size now. Earlier, the left side of my trouser was big than the right one. I urge people not to ignore any changes occurring in the body and should seek immediate medical attention,” concluded patient Mr. Mahendra Meghani (Name changed).