Massive Tumor Removed

Specialists at Schneider Children’s performed a 40-hour operation to remove a huge tumor in its entirety from the base of the skull through the nose

7-year-old Zoya lived with her mother in Russia, about an hour’s distance from the North Pole. She was recently diagnosed with a huge chordoma* tumor the size of a tennis ball located at the base of her skull and extending over the first two cervical vertebrae, which was pressing on the brain stem. This type of tumor is extremely rare appearing in only 1 in 10 million children. Doctors in Russia were unable to treat her and told them there was no way they could reach the tumor to remove it. Zoya’s mother did not give up her search until she found Dr. Amir Kershenovich, Director of the Neurosurgery Unit at Schneider Children’s, who told her that he could remove the tumor and save Zoya’s life.

The team of surgeons prepared intensively in advance of the operation to remove the tumor. Because its sensitive location presented a significant challenge, doctors readied for the possibility that the tumor might have to be removed through the nose, mouth or an incision at the back of the skull. To perform the complex, delicate and lengthy operation, the multidisciplinary medical team comprised skilled and experienced neurosurgeons, otolaryngologists, anesthetists, electrophysiologists, surgical nurses and intensivists.

Sunday, August 11th: The operation ensued over several consecutive days. Working side by side through long hours, the team headed by Dr. Kershenovich and Dr. Eitan Sudri, Director of the Nose and Sinus Unit in the ENT Department at Beilinson Hospital, together with anesthetists, Dr. Evelyn Trabkin and Dr. Konstantin Nikarsov, succeeded in removing most of the tumor after 19 hours straight.

A few hours later on Monday, the team led by Dr. Dennis Pushkov, senior neurosurgeon at Beilinson Hospital, affixed the skull to the neck in another 4–hour procedure. Three days later, surgeons continued the operation and after another 17 straight hours, succeeded in removing the remaining tissue of the tumor in its entirety.

A total of 40 hours of highly skilled and concentrated surgery was required to remove the growth from Zoya’s skull. Using delicate techniques and with great patience, physicians were able to reach all parts of the tumor and gradually excise it with a special device through the child’s nose. To everyone’s utter joy, and against the stacked odds, the team performed the procedure without the need to make an incision in the back of Zoya’s skull. The child recovered initially in the Pediatric Intensive Care Unit after which she was transferred to the Surgery Department for follow-up observation and care. Zoya and her mother will shortly return home to Russia.

Zoya’s mother said emotionally, “I am deeply grateful to the team of doctors and nurses at Schneider Children’s, who succeeded in saving my daughter’s life.”

Noted Dr. Kershenovich, “We routinely perform neurosurgeries at Schneider Children’s to remove tumors from the brain and spinal column, but a tumor of this size is very rare. One of the most exciting moments in a neurosurgical procedure is the instant when you know that you have succeeded in removing the entire tumor without any collateral damage to tissues or brain function. It is due to the skill and experience of the operating team, together with expert pediatric anesthetists, that we succeeded in removing the tumor through the nose and saving the girl’s life. I am moved to see Zoya as she is now, after the operation.”

* Chordoma is a rare type of cancer that occurs in the bones of the skull base and spine, and account for about 3% of all bone tumors.