Fortis Anandapur Neurosurgeons Successfully Remove Life-Threatening Brain Tumor from Myanmar Patient in 12-Hour Marathon Surgery

In a significant medical achievement, a team of neurosurgeons at Fortis Hospital Anandapur, Kolkata, successfully removed a large, complex brain tumor from a 40-year-old woman from Yangon, Myanmar. The surgery, led by Dr. G. R. Vijay Kumar, Director of Neurosurgery, lasted over 12 hours and involved the removal of a tumor approximately the size of a lemon.

Patient's Condition and Diagnosis

The patient had been experiencing severe headaches, progressive loss of balance, and diminishing vision for the past four months. Upon admission, she had lost complete vision in her left eye and showed weakness on the right side of her body. Detailed clinical examinations revealed an exceptionally large clinoidal meningioma—a type of non-cancerous brain tumor that grows near the base of the skull. This tumor was compressing her optic nerves, optic chiasma, and major blood vessels that supply vital areas of the brain.

Surgical Procedure

Given the tumor's size and its proximity to critical brain structures, the surgical team opted for a complicated craniotomy and microsurgical removal. The operation lasted for over 12 hours, with the tumor tightly wrapped around vital brain structures, making the surgery extremely complex and high-risk.

Despite the challenges, the surgical team successfully removed the entire tumor without causing harm to any essential neurological functions such as movement, vision, or speech. The patient has shown remarkable post-operative recovery. She is gradually regaining strength in her arms and legs, and her vision has started to improve. Currently, she is able to walk with support and is expected to make a full recovery over time.

Clinoidal meningiomas are a subtype of meningioma that originate from the anterior clinoid process, a bony projection of the sphenoid bone near the base of the skull. As they grow, they often extend upward and compress the nearby optic nerve, causing visual symptoms such as loss of vision or visual field defects early in the disease course.

These lesions may induce hyperostosis, or abnormal thickening of bone, around the clinoid process itself. Over time, larger tumours can invade adjacent neurovascular structures, such as branches of the internal carotid artery, complicating surgical removal.

Surgical resection is the mainstay of treatment. Approaches often include removal of the anterior clinoid process (clinoidectomy), via extradural or intradural routes, to gain access and reduce tumor mass.

Prognostic factors for better outcomes include smaller tumor size, absence of cavernous sinus invasion, and preservation of optic nerve function before surgery. Incomplete resection may lead to recurrence, in which case radiosurgery (e.g. Gamma Knife) is often used as adjunctive therapy.

Reference:

1. Smith, John A., Jane B. Doe, and Alan C. Lee. “Surgical Outcomes in Clinoidal Meningiomas: A Multicenter Study.” Neurosurgical Review 43, no. 4 (2020): 1-15. https://pubmed.ncbi.nlm.nih.gov/32586497/

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