Dubai: In yet another medical feat, a team of doctors at Aster CMI Hospital
successfully removed a humongous tumor from a 31-year-old, Manbodh Bagh from Titilagarh,
Odisha, who had been suffering from a rare condition, plexiform neurofibroma, a benign tumor of
peripheral nerves since childhood. As a result of this condition, he developed a tumor on his face,
and it grew as he aged. The tumor was massive, weighing 8+kg and was a bulky mass drooping
from the right side of his face. He faced humiliation from several people due to his looks and had
visited multiple hospitals earlier for partial resection of the tumor.
However, he was deniesurgery as his chance of survival was bleak if they had gone ahead with his surgery due to the risk
of torrential bleeding. At a major hospital in Odisha, his case was reviewed, surgery was
attempted and was later abandoned due to uncontrolled bleeding.
Manbodh’s condition became his source of misery and he desperately wanted to get rid of it. His
hope soon arrived in the form of few well-wishers, the Newslions Media Network Pvt Ltd
facilitated the treatment along with Milaap through a crowdfunding effort to provide him this life-
changing surgery of multiple sittings. Post this, he visited Aster CMI Hospital in Bangalore for
treatment where his condition was evaluated carefully, and his case subsequently accepted.
Manbodh had to undergo 16 different surgical procedures over a period of six months to get rid of
the tumor by a team of doctors at Aster CMI, involving neurosurgery, plastic surgery, oncology,
ENT, neuro-anaesthesia and ophthalmology, amongst the various departments, headed by Dr. Ravi
Gopal Varma, Lead Consultant – Neurosurgery & Chief of Neurosciences; Dr. Madhusudan G, Lead
and Senior Consultant – Plastic Surgery; Dr. Sathish M S Vasishta, Consultant – Craniomaxillofacial
Surgery; Dr. Ravindra Battu, Sr. Consultant Ophthalmology; Dr. Raghavendra Pai K, Lead
Consultant – Neuroanaesthesia; Dr. Girish G, Consultant – Surgical Oncology; Dr. Santhosh N U,
Consultant – Neurosurgery & Endovascular Neurosurgery and Dr. Nirmala S, Consultant –
Neurosurgery and a team of other doctors and surgeons.
The huge tumor was on the right side of face, head and neck, and infiltrating into the right orbit
and completely engulfing the right eye. This made the surgical removal difficult and risky. Speaking
about the complications involved in Manbodh’s surgery, Dr. Ravi Gopal Varma, Lead Consultant –
Neurosurgery & Chief of Neurosciences, Aster CMI Hospital said: “Manbodh came to us with a
prodigious tumor extending from his head till the neck. After undergoing unsuccessful debulking
surgeries, his tumor was deemed inoperable. His CT scan also showed his facial bones were
destroyed by the tumor. Dealing with such a highly complex cases often requires different
modalities of treatment and a multi-disciplinary approach. So, the team carefully evaluated the
case and provided a seamless approach to the treatment. During the surgery to minimize the
bleeding, we planned for preop tumor embolization. The DSA Angiogram showed a significant
tumor blush supplied by multiple branches of facial artery, internal maxillary artery, superficial
temporal artery and ophthalmic artery. Super selective catheterization of those multiple branches
and tumor embolization was done using PVA Particles. The Final Angiogram showed a significant
decrease in tumor blush which minimized the bleeding during surgery. The team finally were able
to remove the tumor and restore the facial bone which was made possible due to the highly skilled
doctors at Aster CMI, backed by state-of-the-art infrastructure and world-class medical equipment
required for safe and secure surgery.”
Dr. Sathish M S Vasishta, Consultant – Craniomaxillofacial Surgery, Aster CMI Hospital said: “The
tumor involved his part of forehead, orbit, maxilla, Zygoma, and half of the lower jaw along with
the involvement of right temporomandibular joint. Since the tumor had destroyed his facial bones,
the challenge was to restore it after the removal of the tumor. With his CT scans data, a 3D printed
skull model of his face was made to assess extent of the tumor and designed excision plan and
reconstruction.”
Dr. Madhusudan G, Lead and Senior Consultant – Plastic Surgery, Aster CMI Hospital said, “Once
the tumor was removed, we took Manbodh up for reconstruction surgery after 48 hours. Most of
his facial skin had to be removed as the tumor was densely adherent, resulting in a large
composite skin and soft tissue defect over the entire right half of the face. Reconstruction of such
large defects which need microsurgical tissue transfer was challenging due to preoperative
embolization.
The entire reconstruction surgery was done in two stages by using three flaps skin
and muscles of both his thighs as well as the right forearm. In the first stage right thigh skin and
muscles were transferred by microsurgical means and in the second stage, a rare complex
reconstruction method was used by connecting left thigh skin- muscle flap to his right forearm skin
and transfer the combination of two flaps to the face by attaching hand to the forehead for three
weeks.”
Dr. Raghavendra Pai K, Lead Consultant – Neuroanaesthesia, Aster CMI Hospital said “Manbodh
was weighing 58 kg with the tumor. On 1 st Dec’2020, the day of the first resection, which lasted for
19 hours where he suffered torrential blood loss and was transfused nearly 40 litres of fluids,
blood and blood components. We had reserved 12 units of blood for this surgery, which is huge by
regular standards and were able to get additional 8 units of blood in a short span of time. Since his
tumor was affecting his mouth opening it was a challenge to get his breathing tube into his
trachea for his first surgery.
After 3 days of stabilization in the ICU, he underwent the
reconstruction surgery which lasted for an additional 23 hours. We also took care of him in our
Neuro ICU. We were able to mobilize Manbodh on the 15th day in the ICU and shifted him to the
wards on Day 18. He then weighed about 44kg. The successful management of complex surgeries
like these are possible when we have dedicated and capable teams under the same roof.”
Explaining his plight, Manbodh, said: "In the hope of getting the tumor removed, I had consulted
various doctors and visited multiple hospitals but all in vain. I was hesitant and shy to go outdoors
due to the tumor. My life had become miserable. Finally, I came to know about Aster CMI Hospital
and consulted the doctors here. They assured me of the best treatment and removal of this tumor.
Newslions Media Network Pvt Ltd & Milaap crowdfunding platform also came forward to support
me. I am elated and no words are enough to express my joy. I am thankful to all the doctors at the
hospital who have given me a second chance to live again.”
Manbodh is now leading a happy tumor-free life and post treatment, he recovered speedily, was
discharged from the hospital with no complications and went back to his hometown with a big
smile on his face.
