Apollo Proton Cancer Centre (APCC) has successfully treated a rare skull base tumor in a 30-year-old athlete from Bahrain. Led by Dr. Joy Varghese, Senior Consultant – Neurosurgeon & Neuro-Interventional Surgeon, Apollo Proton Cancer Centre, Chennai and Dr. Venkat Karthikeyan, Senior Consultant – ENT Skull Base Surgeon, Apollo Proton Cancer Centre, Chennai, the team carried out the complex surgery which spanned over 26 hours, highlighting the center’s unwavering commitment to delivering world-class healthcare solutions.
The young woman, an executive at a prominent company and an athlete, was presented with alarming symptoms including two episodes of blackouts within a month, loss of sensation around the right ear, and weakness in her right shoulder, particularly noticeable during her athletic pursuits as a triathlete.
Upon thorough radiological imaging, medical experts identified a tumor of moderate size located perilously close to the brainstem, in the right jugular fossa along the skull base. The tumor posed significant challenges due to its location, compressing major blood vessels and impinging on crucial nerves responsible for various functions including swallowing, speaking, and shoulder movement.
Adding to the complexity of the case, angiography revealed an absent venous system on the left side, necessitating meticulous planning to ensure the preservation of the patient’s only jugular vein on which the tumor was piggy backed, which was crucial for her survival.
Dr. Joy Varghese, Senior Consultant – Neurosurgeon & Neuro-Interventional Surgeon, Apollo Proton Cancer Centre, Chennai, elaborated on the challenges faced during the intricate procedure. “Our primary objective was to remove the tumor while preserving the vital jugular vein intact. This required meticulous dissection and careful management of the surrounding nerves and blood vessels.” Further, he said that a continuous nerve monitoring and extreme pre-surgical planning were instrumental in achieving the desired outcome for the patient.
The multidisciplinary team employed advanced techniques including sophisticated radiological imaging, per operative electrophysiological monitoring [to know the integrity of nerves while operating] and digital subtraction angiography (DSA) to map out the vascular anatomy and execute precise microsurgical excision, ensuring optimal outcomes for the patient.
Dr. Venkat Karthikeyan, Senior Consultant – ENT Skull Base Surgeon, Apollo Proton Cancer Centre, Chennai said, “Post-surgery, the patient experienced remarkable improvement in her condition, with restored speech and swallowing functions, and no recurrence of shoulder weakness. While mild facial weakness was anticipated, she is currently on a path of steady improvement.”
The patient said, “The doctors at APCC explained the process step-by-step and a clear picture was provided as far as the procedure was concerned. Along with these details, we were also told about the possible risk factors and the potential complications we may encounter but I was not afraid , as I had the confidence and trusted their expertise.”
Histopathological examination revealed a schwannoma, a rare type of tumor originating from the nerve sheath at the skull base. The patient will continue to receive close follow-up care and rehabilitation to support her ongoing recovery journey.
The successful treatment of this challenging case underscores the dedication and expertise of the medical professionals at Apollo Proton Cancer Centre, Chennai, reaffirming the region’s position as a hub for advanced healthcare solutions.
