A woman with a cyst weighing the same as ten newborn babies has finally had the five stone tumour removed to save her life.
The unnamed 24-year-old, from Mexico, noticed she was gaining weight despite being on a diet. But scans later revealed she was suffering from an ovarian cyst which grew ferociously over 11 months.
By the time of surgery it had a density of five stone and put her at risk of heart failure as it crushed her internal organs, meaning she had problems walking, breathing and eating.
Last year, Dr. Erik Hanson Viana at Mexico’s General Hospital performed pioneering surgery to remove the cyst – believed to be the biggest-ever removed whole.
Now, more than six months on, the patient has regained mobility and returned to a normal life.
Dr. Hanson, from Mexico City, said: ‘This is the biggest cyst I have operated on, it was so large that it took up 95% of the patient’s abdomen. It’s really rare to operate on a cyst this big, it measured half a metre in diameter and the circumference was 157 cm.
‘From all the research I’ve found, this is the largest ovarian cyst ever to be removed whole without draining it first or spilling it.
‘The largest in history weighed 320lb back in 1902, and took several days to drain, I can’t even imagine one that large.’
He added: ‘The patient was quite overweight, so after starting on a diet, she noticed her face, arms and legs were getting thinner but her stomach was getting bigger.
‘When I met her, she could just about walk a couple of steps before getting agitated and feeling like she was struggling to breathe because the cyst was crushing her lungs.
‘Some experts say a giant cyst is anything bigger than 10cm, others that it has to weigh over 26lb (12kg) or that it has to be higher than the umbilical of the patient – this cyst was much bigger than all of them.
‘If we hadn’t operated it would have gotten to the point where she wouldn’t have been able to walk, would be severely malnourished and unable to eat. It’s hard to say how long she would have lived, but it would have been a really bad quality of life.
‘Two days after surgery she walked out of hospital. Before she was used to carrying 73 lb (33kg) inside her because of the cyst, so movement was like she was levitating or walking on the moon.
‘When we saw her six months after surgery to see how the scar was healing and monitor for other problems, she was fully healed. She was standing completely straight. She now walks like a normal person without needing a walking stick or other mobility aids and her abdomen is now flat.’
The patient was referred to Mexico General Hospital as a last resort due to the concerning size of the cyst and complicated surgery needed to remove it.
Dr. Hanson said: ‘Since the cyst had become so large, it had started to compress her intestines and was preventing her from eating.
She would be full after eating a tiny bit of food and because of the cyst’s size, it was harder for food to pass from the stomach.
‘The cyst was also compressing the two main vessels in the body since is a vain and an artery, which could have led to serious heart problems.’
Due to its size, Dr. Erik Hanson and Dr. Abel Jalife removed the tumour whole fearing that draining the cyst could put the patient’s life at risk. Up to 20% of giant ovarian cysts are malignant, meaning that if the cyst was pierced it risked leaking tumorous cells into the patient’s body.
‘Draining beforehand can be dangerous, if any of the fluid spilled it risked contaminating the patient’s abdominal wall and spreading tumour cells,’ he added.
‘But to remove it whole is also difficult because the cyst wall is less than one millimetre thin and needs to be prevented from drying out, otherwise it could easily break too.’
‘There’s no real consensus in the medical community about which is the best technique to operate on giant cysts.’
The patient chose to take out the ovarian cyst completely rather than draining it first, despite knowing she would be left with a lengthy scar.
‘She went for the open procedure knowing there would be a big scar from her chest to her pubic area, she wasn’t very concerned about the aesthetics and was happy.
‘She had bad stretchmarks on her abdomen and the skin on her abdomen was wrinkled, but now the abdominal wall has returned to the place it should have.’
The woman has now returned to her normal life in a rural part of Mexico, living a day’s travel away from Mexico General Hospital.
Dr. Hanson said: ‘A big part of what we do is the gratification you feel when you could change a person’s life completely, and knowing they would never forget you, even if they forget to say thank you.’