Last month, Healthscope’s Sunnybank Private Hospital treated a patient with a large retroperitoneal mass. The patient, a 48-year-old male who was otherwise fit and well first presented with noticeable abdominal swelling over three months. Other than this, he remained symptomless.

He was referred to see Professor Terence Chua with a CT scan of his abdomen which showed a large mass that was noted to be heterogeneous, with several cystic spaces measuring 101x86x90mm. The patient underwent inpatient investigation with gastroscopy and colonoscopy which was unremarkable and a series of other clinical investigations.

         

Following a period of medical therapy involving hormonal blockade with endocrinologist Dr Su Mien Yeoh, to reduce the functional effects of this rare tumour, a procedure was then performed by Professor Terence Chua jointly with vascular surgeon Dr Nigel Pinto and General Surgeon Dr Peter Yuide. Through careful and precise surgical dissection, a mesenteric window was created through the transverse mesocolon, preserving the vasculature of the colon allowing an anterior approach to the tumour.

A capsular dissection followed and as the vascular pedicle was approached, the patient’s systolic blood pressure began to rise to almost 290/120. This was promptly anticipated by our anaesthetist Dr Khai Van who commenced a string of anti-hypertensive to assist with blood pressure control.

The tumour feeding veins were ligated and the hormonal cause of his hypertension immediately abated. The tumour was dissected off the abdominal aorta by Dr Pinto with two feeding arteries controlled by suture ligation. The tumour was removed fully en-bloc. The patient made a good recovery initially in ICU on the first and second postoperative days and was discharged home on day four.

Professor Terence Chua is an expert cancer surgeon who believes that a successful cancer operation that cures is a culmination of a careful plan orchestrated by the lead surgeon through collaborative decision making involving other surgeon colleagues, medical oncologists, radiation oncologists and pathologists. The patient has had a very good recovery and this is a testament to the care provided to him by the whole team at Sunnybank Private Hospital.