Rare 3 kg Thoracic Lipoblastoma Removed at Zydus Cancer Hospital
Lung and thoracic cancers in India have risen sevenfold over the past decade, with nearly 75 % of patients diagnosed at an advanced stage. In this context, an 11‑year‑old girl from Ahmedabad presented with chronic exhaustion; an ECG flagged an abnormal heart position, prompting X‑ray and CT imaging that revealed a large mediastinal mass. A 2‑D echocardiogram mimicked dextrocardia because the tumour, weighing 3 kg and extending 23 cm, mechanically compressed the left lung, the middle lobe of the right lung, the diaphragm, the heart, and the inferior vena cava (IVC). The compression caused lung tissue rupture, haemoptysis, diaphragmatic displacement, IVC narrowing, hepatic congestion, and enlargement of the liver.
Dr. Mahesh D. Patel, GI, Lung and Thoracic Oncology Surgeon at Zydus Cancer Hospital, led the operation. Anticipating arrhythmia risk, a defibrillator was kept on standby. The surgical team employed a clamshell incision approximately 30 cm wide to provide full exposure without further heart compression. After three hours of meticulous dissection, the tumour was mobilised, guided leftward, and excised completely. Immediate lung reinflation occurred once the compressive force was removed. The patient’s heart gradually returned to its normal position, and she was discharged within a week, regaining stamina and normal activity levels. Histopathology confirmed the mass as a lipoblastoma, a rare benign tumour of immature fat tissue; the previously largest reported thoracic lipoblastoma weighed 0.9 kg.
The press release also references two additional complex cases handled by Dr. Patel. An 11‑year‑old boy with a 22 cm mediastinal germ‑cell tumour required ventilator support; after chemotherapy normalized tumour markers but not size, a clamshell incision was again used for complete resection, leading to discharge within a few weeks and continued cancer‑free status. An 80‑year‑old African patient presented with a 3 cm mediastinal paraganglioma situated between the superior vena cava, aorta, pulmonary artery, descending aorta, and trachea. Dr. Patel performed a robotic resection through a 2 cm incision, avoiding sternotomy; this approach is among only five such robotic mediastinal tumour resections performed worldwide and the first in India. The patient recovered well and was discharged in a week.
Dr. Patel’s broader portfolio includes India’s first 3D‑printed sternal implant, the nation’s inaugural robotic resection of a segment‑1 hepatocellular carcinoma, tracheal resection under ECMO, complex IVC and abdominal aorta resections, superior vena cava (SVC) resections, chest‑wall reconstruction for invasive thymoma, and a modified Appleby procedure for pancreatic cancer. His work has been featured in a coffee‑table book titled Surgical Marvels.