Gupta was admitted to the Department of Orthopaedics at Sir Ganga Ram Hospital on December 26 with huge swelling in his left thigh.
For 18-year-old Praveen Kumar Gupta, last one month is nothing short of a miracle, after doctors at a Delhi hospital removed his tumour in the thigh, which has become the largest in-situ (inside body) tumour in the world.
Gupta was admitted to the Department of Orthopaedics at Sir Ganga Ram Hospital on December 26 with huge swelling in his left thigh. The swelling, which appeared in 2012, increased to the current size, which, as revealed by the investigations was 37cmx18cmx12cm, involving the hip and the full length of the thigh. He had lost sensation in the limb and was weak due to pressure on the nerves and blood vessels.
“The tumour was perfused by rich blood supply making it highly vascular in nature. Before the removal, our team performed a procedure called pre-operative embolisation, a night before surgery. We blocked the blood supply to the tumour to reduce blood loss during the surgical excision. The main challenge was that blood supply of the tumour was adjoining the main blood supply of the lower limb. Any untoward incident could have led to disastrous amputation. With this in mind, using road-map guidance software, we blocked the main blood vessel supplying blood to the tumour without compromising blood supply to the limb,” said Dr Ambrish Satwick, Vascular and Endovascular Surgeon, Sir Ganga Ram Hospital.
After cutting the blood supply to the tumour, Gupta was taken for surgery, which was performed earlier this month on January 3, 2019, by a team comprising seven surgeons. The surgery took nine-and-a-half hours and only one unit of blood was transfused. He recovered soon after the tumour was removed and started walking with the help of walking aid from third post-operative day.
“This was a challenging case for anaesthesia because it was a long surgery performed in the prone position (lying on abdomen), which has its own problems. Blood loss was anticipated, but was managed with meticulous surgical and anaesthetic technique,” said Dr. Jayashree Sood, Chairperson, Department of Anaesthesiology, Pain and Perioperative Medicine, Sir Ganga Ram Hospital.
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 "Praveen Kumar Gupta")
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