Complex tumor surgically removed at Thumbay Hospital helps Nigerian schoolteacher regain voice

Stella is now able to swallow food and drinks without any difficulties

The most endearing aspect of life for 58 year old Stella Nwanganga Ntiajuka was her job as a primary school head teacher in her hometown Lagos in Nigeria. She had been thoroughly enjoying her role for many years and was very fond of her students, as they were of her. The thought of a busy day at the bustling school premises was something she woke up looking forward to, every day.

Early last year, Stella started experiencing difficulties in her throat, which started as a difficulty to swallow solid foods, accompanied by hoarseness of voice. By April 2018, she noticed the appearance of a sizeable lump on her throat. She didn’t worry about it at first, but as days passed, she experienced a worsening discomfort in her throat. Even when she tried to swallow the food by flushing it down her throat with water, she wasn’t very successful. This resulted in an alarming decline in weight to almost 18 kilograms.

She approached a local hospital in her hometown, expecting to be diagnosed with either malaria or typhoid. Little did she know that this would be the start of a harrowing journey from one hospital to another and from one diagnostic lab to another. Despite seeing several doctors, her illness could not be diagnosed. In July 2018, an ENT specialist at one of the hospitals referred her to a university teaching hospital.

At the university teaching hospital, she had appointments with a specialist doctor twice a week. She underwent several diagnostic tests, X-rays and even biopsy, over a period of time. Finally, the biopsy result revealed ‘benign spindle tumor in the neck’. However, the hospital couldn’t operate her because of the risk involved due to the critical location of the tumor. The tumor was located on her throat such that any surgical intervention would involve the risk of turning fatal.

Stella started finding it increasingly difficult to eat food, either solid or semi-solid, and to even drink water. She was unable to sleep at night, and was losing weight rapidly due to decreased food intake. When she couldn’t bear it anymore, her family decided to look for options abroad. They discussed this with her son, who in turn suggested Thumbay Hospital – Ajman, based on positive feedbacks he had heard about the hospital.

She was attended by Dr Hillol Kanti Pal, Medical Director and Consultant Neurosurgeon at Thumbay Hospital, Ajman. Observing her in the OP department, Dr Hillol noticed the sizeable mass on her neck occupying the right carotid triangle, an area through which runs the common carotid artery and the internal jugular vein. After preliminary and detailed investigations, and in the light of the biopsy report from her home country, Dr Hillol diagnosed her with Neurofibromatosis type 1 (NF1). She was in the O-ve blood group, making the prospect of a surgical intervention even more complex. “Her difficulty in swallowing food – called ‘Dysphagia’ in medical parlance – had caused her to lose 18 kgs of body-weight in just a few months. As we prepared for the surgery, perhaps the biggest challenge in addition to her rare blood group was that she had hardly eaten for 8 months. She also had diabetes mellitus, meaning the post-operative wounds could take longer to heal,” Dr Hillol recounted.

Dr Hillol assembled a team of surgeons of the hospital, for the procedure. “This was a tough task for one individual alone to perform. We also arranged several consultation sessions for the patient and her husband, with the team that would be performing the surgery. This was important to make them understand the process involved, as well as to allay their apprehensions,” he said. The team of surgeons included Dr Rajesh Sisodiya – Specialist General Surgeon, Dr Faisal Ameer, Specialist Plastic Surgeon and Dr Rohit Gulati, Specialist ENT Surgeon.

Stella underwent 3 surgical procedures: the first one to insert a pipe through her nose, so that she could take fluid food. The second procedure was to prevent the growth of the tumor and the third one was to remove the entire tumor. The complete procedure took a total of around six-and-a-half hours. “Only one unit of blood was used throughout the entire procedure. The happiest moment for us was when, 24 hours after the surgery, the patient was able to move her hands and she held my hand and smiled,” Dr Hillol said.

The tumor was completely removed, and Stella is now able to swallow food and drinks without any difficulties.

Having regained her normal self, Stella says she is looking forward to resume doing what she loves best – teaching. “I miss the school and my students. I am happy that I can now return to teaching,” she said.