Patient Story 2The Times of India
6th October 2011
Doctors save man’s arm, remove 1.5 kg tumour
Beach ball-sized growth is largest desmoid fibrosis reported in medical journals
Pratibha Masand | TNN

For Arvind Shah (34), the last four years have been marked by endless visits to hospitals, consultations with doctors and even more tests. What started out as an innocuous swelling in his left shoulder in 2007 had grown into a huge mass the size of beach-ball, which extended from his neck to the under arm. Doctors who identified the rare tumour for what it was—desmoid fibromatosis—recommended amputation. And just as Shah resigned himself to a life without one arm, hope came in the form of a team of doctors who were able to remove tumour without amputating the limb.

“It was a while before my condition was diagnosed correctly. Most of the doctors I consulted said it was a cancerous growth in their preliminary examination. But then the MRI reports would prove them wrong. I kept ignoring it. I didn’t want my arm to be amputated; who would marry me?” asked the Bhayendar-based bachelor who felt is marital prospects would reduce significantly if he had only one hand.

But by June 2011, the pain had become unbearable, as the mass had infiltrated his chest and shoulder muscles. It was then that Shah was directed to cancer surgeon Dr Amit Gandhi who took a month to study the case before he opted for surgery in August. Gandhi decided to try and save the arm, and assembled a team of doctors. “We had to remove both his collar and shoulder bone. Only the socket part of his shoulder was left. We also had to remove sections of his muscles,” said Gandhi. The complicated surgery was performed at Vertex Hospital in Mulund.

The team was able to save the nerves in region, which means that Shah can move his arm and use his fingers. “We had to be very careful with the brachial nerves, which are responsible for the function of his hand. It was even more difficult as the nerve branches further into three cords—all three had to be saved so that he could retain movement.”

The surgery, which took place in August 2011, was a success, but Shah’s post-operation follow-ups are still underway.

° Arvind Shah (name changed) was diagnosed with desmoid fibromatosis, a benign and slow-growing tumour that spanned his neck and underarm
° The mass had also infiltrated his chest muscle, shoulder muscles and axillary vessels, which carry blood to the arm

° To get to the tumour, doctors had to make three incisions in the patient’s shoulder area
° While doctors were able to save his arm, they had to remove the muscles and bones surrounding the tumour, including the collar bone and shoulder bones, as well as a section of his chest and shoulder muscles

° Doctors were able to save the ball and socket joint of his shoulder. Shah can move his hand except rotate it.
° Doctors saved the axillary nerves of the arms. This means that Shah has feeling in the operated arm and can also move his fingers
° Shah will undergo radiotherapy sessions to reduce the risk of the tumour recurring
° When removed, the mass weighed 1.5 KG — the heaviest reported desmoid tumour in the world, say doctors who operated on him. Its dimensions were 15X10X14 CM — roughly a size of a beach ball.

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