Dr. Archit Pandit, Director & HOD, Surgical Oncology with the patient Zainab
10-year-old girl, Zainab, from Iraq, was suffering from pain in the abdomen, abdominal distension, and difficulty in eating for past one month or so. She also experienced early satiety (a feeling of fullness) after meals. The parents were worried, seeing their child in an agitated condition and not eating properly. They consulted a local doctor in Iraq and some tests were conducted, such as blood work-up and ultrasonography, which revealed a mass in her ovary. Further tests were performed, and Zainab was diagnosed with ovarian cancer. She underwent surgical treatment in Iraq, where the cancerous ovary was removed. The doctors also recommended chemotherapy, but her family refused. Later, the patient developed recurrence of symptoms like abdominal pain and distention.
They came to India and visited a hospital with these complaints. She was re-evaluated with blood tests, imaging tests and biopsy which revealed she was suffering from Recurrent Germ Cell Tumour of Ovary. She received 4 cycles of Chemotherapy, however the tumour still persisted.
They visited SHALBY Sanar International Hospitals for further treatment and consulted Dr. Archit Pandit, Director & Head of Department, Surgical Oncology. A PET scan was done, which showed a larger left ovarian mass and a surgery was planned to remove it. The tumour was bigger and more complex due to re-surgery. She was operated on in the first week of December. Intraoperatively, the doctors saw the left ovary and a large ovarian mass involving the colon with deposits on the intestines, uterus and the kidneys. The mass and deposits were found to be cancerous. Excision of the ovarian mass was done. The colon was freed, and the cancerous deposits were removed successfully. The pelvic lymph nodes and the abdominal fat layer called the Omentum were also removed.
Sharing his insights on this challenging case, Dr. Archit Pandit added, "Navigating the intricacies of treating young patients, especially children, adds a layer of complexity, particularly when fertility concerns are paramount. In the case of this young girl, Zainab, who had undergone a prior surgery in Iraq, we faced a unique set of challenges. The initial surgery had removed her left ovary, and when she came to us, we discovered not only the presence of the left ovary but also a larger ovarian mass.
Undertaking a re-surgery brought its own complexities – the intestines, large intestines, uterus, and kidneys were all entangled due to the previous procedure. Our first challenge was to untangle the organs and eventually safeguard the right ovary and the uterus. Preserving the child’s fertility became a crucial aspect of our mission.
Amidst these challenges, we successfully performed the surgery and post-operatively, the patient did well. She was started on a diet on the second day and discharged on the fourth day without any symptoms.
Dr Pandit concluded, “In the realm of ovarian cancer, where preserving fertility is a delicate task, we take pride in having achieved that for Zainab. Our success extends beyond medical expertise; it's about making a lasting impact on a young life and contributing to a hopeful future for both the patient and her family."