A rare surgery has been performed on an 11 years old girl child with a huge neck mass at Alchemist Hospital. Surgery was performed by Dr. Prachi Jain, Consultant ENT Alchemist Hospital, Panchkula.
Patient was found to have a slight swelling in the lower part of the neck , incidentally noticed. On investigation it was found that the mass was extending from the neck to the great vessels of the heart going into the chest. It was extending up to the vertebral column( spine) in the neck and surrounded by vessels taking the blood to the brain. It was compressing the wind pipe and causing her to have breathing difficulty. It was suspected to be a teratoma on CT scan. It's a rare tumour to be present in the neck with such extensive presentation.
Patient underwent excision of the tumor. Putting the tube for general anaesthesia was a challenge as the tumor was compressing the wind pipe. The anaesthesia team (under the leadership of Dr Akaljot) was able to do that successfully without doing a tracheostomy/ cutting the wind pipe. The tumor was removed successfully without injury to the surrounding structures such as wind pipe, food pipe, great vessels of the neck and heart. The whole mass was removed through the neck without cutting open the chest.
Dr Prachi told that excision of tumour was done without any complication. Utmost care was taken to prevent injury to nearby structures. Postoperatively patient remains stable. Histopathology examination confirmed mature cystic teratoma.
She further told that teratoma arise frequently in ovaries and testes and are uncommon in neck. Such huge teratomas are very rare. It poses clinical and radiological difficulty. Because of the location and size of the teratoma, the risk of wind pipe being fragile and bucking under pressure was there. There was a risk that wind pipe may have to be opened up to maintain airway, but it could be done without any damage. Surrounding organs such as thyroid, wind pipe, food pipe and great vessels may be at risk. Great surgical expertise is required to avoid injury to these organs.
Patient has been discharged and is recovering well.