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The World's Largest Tumor Removed

Tumor

The World's Largest Tumor Removed

Surgery

CNN Sunday, January 8, 2012 -- A Vietnamese man is recovering in the intensive care unit Friday, a day after surgery that completely removed from his right leg a tumor twice his body weight, according to the hospital in Ho Chi Minh City. The tumor was first discovered when Hai was four years old and had grown to its enormous size since then.

The growing tumor had rendered the patient, Nguyen Duy Hai, virtually immobile until his surgery.

The excised tumor weighed 180 pounds (82 kilos), according to the hospital, a bit less than the 200 pounds (90 kilos) estimated before surgery.

Hai, 31, of Da Lat City, has Von Recklinghausen's neurofibromatosis, said Dr. Jean-Marcel Guillon, chief executive officer of FV Hospital, where the 12-hour procedure was performed.

The autosomal dominant hereditary disorder is the same disease that contributed to the extraordinarily large head of Joseph Merrick, whose story was dramatized in the 1980 film, "The Elephant Man," explained Guillon. (Last July, according to the U.S. National Institutes of Health, its researchers identified the gene variant in Proteus syndrome and plan to test DNA from Merrick's skeleton to determine if Proteus caused his disfigurement.)

The tumor, which originated in Hai's spine, "may return," Guillon wrote in e-mails to CNN, "but we can operate him again, and it won't ever reach such a size anymore."

Doctors expect that Hai's cardiac and pulmonary functions will return to normal during the next 10 days. After that, Hai faces rehabilitation, physical therapy and possible help from the hospital's clinical psychologist to deal with issues pertaining to body image, Guillon said. "This patient lived all his life with this tumor. It was part of him."

Hai also needs to learn how to do things that his body had forgotten, including using the left leg he had never used normally, Guillon added.

The latest surgery was considered risky with a 50% success rate for a number of reasons, Guillon explained. "First, such a giant tumor has developed its own blood system with huge arteries branched out from the normal vascular system. Therefore, one of the main risks was abundant bleeding."

Doctors used a "cell saver," which suctions and filters the patient's blood before re-injecting it into the body, along with extra blood for the surgery.

The second and third risks lay in heart function ("How would a heart react when a tumor with twice the weight of a patient is removed?") and the effects of a long -- more than 13 hours -- anesthesia, Guillon said.

Leading the surgical team was Dr. McKay McKinnon, a specialist in plastic and reconstructive surgery from Chicago.