UAE: Large tumour removed from Emirati army officer’s chest in rare surgery

An Emirati man, a 44-year-old member of the UAE Armed Forces, is relieved after a large mediastinal tumour has been removed through a rare surgery performed in Abu Dhabi’s Sheikh Shakhbout Medical City in partnership with Mayo Clinic (SSMC).

It was by sheer coincidence that the Emirati man recently discovered a 7cm tumour in his chest following a medical examination.

“I never experienced any pain. My tumour was initially detected during a regular medical examination for work. At that private hospital in Al Ain, there’s an imaging procedure that specialises in detecting cancer cells. The test results showed that I had a lump in my chest. The doctor confirmed the presence of a cancerous tumour. I was referred to SSMC to see Dr Black, as he is a top specialist in thoracic surgery,” the Emirati said.

Dr Edward Alexander Black, consultant thoracic surgeon, is unsure how people get these rare tumours.

“They start off as a benign growth related to immune disease and sometimes change to malignant tumours. These malignant thymoma tumours grow slowly and eventually encase the lung and heart as well as spread around the patient’s body. For this patient, it had not spread beyond the tumour mass. But yes, it is a serious disease.”

Talking about the initial diagnosis, Dr Black said: “This tumour was part of an immune problem of the thymus gland in the chest. This was producing antibodies that affect the ability of nerves to activate muscles, so the symptoms are generalised fatigue that gets worse each day, better after sleep and so on.”

Advanced surgery performed

Usually, the surgery will involve splitting the breastbone, but Dr Black used a minimally invasive approach to remove the tumour, the surrounding tissue, and lymph nodes without splitting his breastbone or ribs.

“Thoracoscopic thymectomy is preferred over open thymectomy as it reduces pain and body stress thus accelerating recovery and reducing complications. However, it is generally much more difficult for tumours greater than 3 or 4 cm diameter. By careful dissection and using a novel technique to extract the mass and attached nodes the benefits of minimally invasive surgery were provided for our patient.”

Dr Black underlined that removing a 7cm diameter tumour was challenging.

“The larger the size the more advanced the tumour and the increased risk that the surgery will be incomplete (small pieces left). Also, larger tumours need combined treatment with radiotherapy as well as surgery. This patient had full removal so radiotherapy was for additional security.”

The tumour was not breached and removed from his body through a small incision on the upper abdomen. The patient didn’t experience any significant pain and was discharged the next morning. He is currently undergoing follow up treatment to ensure that the tumour has the lowest possible chance of recurrence.

“Recurrence is a risk for malignant thymomas, especially the large ones, which is why we provide prophylactic radiotherapy. Recurrence can be very late as these tumours grow slowly so CT scan of his chest will be offered at post operation 1 year, 2 years then every 2 years after that.”

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