Sakra World Hospital treats rare tumour

Patient suffering from Phosphaturic Mesenchymal Tumour was discharged on the very next day post operation

A 66-year-old male patient was recently treated for very rare case of sino-nasal vascular tumour at Sakra World Hospital based in Bengaluru. The patient was suffering from Phosphaturic Mesenchymal Tumour (PMT), Hemangio Pericytoma of Ethmoid Sinus and was confined to a wheel-chair. The placement of the tumour also posed a very big challenge to surgeons as it could easily disturb/damage either the eyes or the brain if there was a slight slip during surgery.

The patient was referred to Prof Dr CV Harinarayan, Director Diabetes, Endocrinology and Osteoporosis, who identified the problem to be the loss of phosphorus from the body. Dr Harinarayan said, “Phosphorus along with calcium, phosphate, vitamin D etc. is an important component for the formation of the bones. In normal conditions the phosphorus is reabsorbed into the body by the kidney but in his case it was excreted resulting in soft bones. Such a condition occurs due to the presence of a Phosphaturic Mesenchymal Tumour which is a rare benign tumour which inappropriately produces a substance known as FGF23 (Fibroblast Growth Factor 23) which decreases the rate of reabsorption of phosphorous in the body.”

Based on the above biochemical assessment, a Positron Emission Tomography (PET) scan was conducted in order to locate the position of the tumour. The scan revealed the location to be at the base of the skull and very close to the eyes and base of brain (Posterior Ethmoidal Sinus).

The Sakra World Hospital team based on the assessment and location of the tumour performed a specialised CT scan and generated a 3D image of the tumour and decided on the complex procedure. “Being a vascular tumour, the risk of blood loss could have been very high and any mishap could have led to serious damages to the eyes and the brain. The navigation assisted endoscopic procedure along with the CT scan helped in successfully performing the surgery with minimal blood loss and without any incisions,” said, Dr Honey Ashok, Senior Consultant – ENT, Head Neck Surgery & Head Neck Onco Surgery.

The patient showed signs of recovery within just a few hours of the surgery and laboratory tests conducted showed a steady rise in phosphorus levels in the body. The patient was discharged the very next day with advice for regular follow up. Now his FGF level has returned to normal.