2020: A 12-year-old boy from Bangladesh diagnosed with giant
nerve sheath tumour measuring 15X15X20 cms covering the entire lower part of the neck,
was removed successfully in a 12-hour marathon single-stage surgery by a team of experts
at Gleneagles Global Health City, Chennai. The boy’s condition was very critical as the
tumour was extending into the left side of the neck and chest cavity.
The boy visited the neurosurgery department with complaints of swelling on the left side of
his neck above the collar bone which was growing backward towards the cervical spine; he
was in pain from the past two years. The tumour had completely destroyed the bones in the
lower neck and the major blood vessels on the left side of the neck were encased and
displaced by this large tumour. His reports confirmed a giant nerve sheath tumour.
A multi-disciplinary team of doctors led by Dr Nigel Symss (Senior Consultant
Neurosurgeon) along with Dr PhaniKiran S (Senior Consultant Spine Surgeon), Dr Rajkumar
(Senior Consultant Vascular Surgeon), Dr Jagannath PM (Neurosurgeons), Dr Arul K
(Neurosurgeons) and Dr Ramana (Neuro-Anaesthetist & Neuro-critical care) after
complete examination and investigations of the boy, decided to remove this large tumour in
a single stage surgery.
Talking about the case, Dr Nigel Symss, Senior Consultant Neurosurgeon, Gleneagles
Global Health City, said, “The advantage of single-stage surgery is less amount of blood loss,
less chances of infection, avoiding a second surgery and a shorter hospital stay. These kinds
of the tumours are a benign schwannoma and are slow-growing; if not diagnosed early may
cause serious neurological deficits and instability of the spine. Giant dumbbell spinal
schwannomas are uncommon lesions and their surgical treatment is demanding and
challenging, requiring a multidisciplinary team approach for achieving good functional
The microsurgical excision of the tumour was performed using a microscope and CUSA. The
nerves and major neck vessels around this tumour were delicately separated by the expert
surgeons in a 12-hour long single-stage surgery.
Dr Rajkumar, Senior Consultant, Vascular Surgeon, Gleneagles Global Health City, said,
“The surgery was so challenging that any damage to the blood vessels or nerves during the
surgery would have led to a major stroke or paralysis to the boy.”
“The accepted treatment for these benign tumours is complete surgical resection where
feasible, and where indicated, vertebral fixation”, added Dr Phani Kiran, Senior Consultant,
Spine Surgeon, Gleneagles Global Health City.
The tumour was removed completely and the destroyed part of cervical spine was stabilized
with titanium cage and plate with screws. He is recovering well and undergoing
physiotherapy and he has no new neurological deficits.