Two-kilo tumour had started to compress heart, major wind pipe, lungs of the patient

Kathmandu, April 6

A 22-year-old man underwent a complex but successful surgery for the removal of a two-kilo tumour from thymus gland, in Bhaktapur Cancer Hospital yesterday. The major surgery at the hospital, which is the first of its kind, has added yet another milestone in the development of oncological surgery services in the hospital, claimed the hospital.

The operation called ‘extended thymectomy’ was conducted on Ranjit Shrestha, a permanent resident of Dolakha district. He is making a good recovery in the intensive care unit of the hospital.

According to doctors involved in the surgery, thymus is a lymphatic tissue that lies in the upper chest under the breast bone in front of the heart and major blood vessels. Its job is to make white blood cells, called lymphocytes, which play a vital role in the immunity system to fight against disease organisms, as well as foreign cells.

Mohan Devbhandari, senior consultant cardiothoracic surgeon, at the hospital who conducted the surgery, explained that this kind of tumour of the thymus gland called thymoma occurs mainly in young adults. “The gland educates the white blood cells in infancy to take part in the immune system of body and fight off illness. Damage to the thymus gland increases vulnerability to infection. But the gland becomes smaller as a young child grows up.”

Devbhandari further explained that Ranjit must have had the tumour for a long time to have reached its present size before being discovered. The size of the tumour had started to compress his heart, major wind pipe, lungs and important blood vessels.

“While conducting surgery, we had to cut his breast bone into two halves to open the front of the chest. We had to sacrifice a major vein draining blood from the head and neck. The tumour had to be very carefully freed from the heart, major blood vessels, and lungs. We also had to cut away one of the arteries, two nerves and 20 per cent of lungs, along with the tumour,” he said. He said the surgery was difficult and took eight hours as the tumour had invaded vital body parts near the thymus.

The patient only had non-specific symptoms of cough for a few months with no other warning signs. Yam Narayan Shrestha, Ranjit’s father, said his son studying bachelor in computers science was in perfect health and had never been diagnosed with any illness prior to the diagnosis of this tumour. When Ranjit started complaining of difficulty in breathing he was taken for health check-up at the Korean Nepal Friendship Hospital in Thimi. From there he was referred to Bhaktapur Cancer Hospital for a CT scan, which led to the diagnosis of the tumour.

Devbhandari added that this type of tumour mainly occurs in people aged 20 to 40 years. If the tumour is detected at an early stage and a surgery is conducted, patients have good chances of a permanent cure. Chances of cure are slim once the tumour matures. In some very late cases, it may not be possible to operate at all.

“In Bhaktapur Cancer Hospital, roughly one such case is reported every few months. There is no specific known risk factor causing the disease, but timely diagnosis and surgery is the best preventive measure,” added Devbhandari.

‘’In the past, patients were being referred to other hospitals or abroad for this type of complication. We are glad that we can now offer this surgery here.’’ Rishikesh Narayan Shrestha, executive director at the hospital, said. Bhaktapur Cancer Hospital is the largest provider of cancer services in the valley. The 110 bedded national hospital provides all types of cancer-related treatments.