The surgery took 2 hours to remove the half-kilogram tumor from the patient's head and 6 hours to reconstruct a large necrotic skin flap to protect the brain.
Today (June 10), Master, Doctor, CKII Chu Tan Si (Head of Neurosurgery Department, Neurology Center, Tam Anh General Hospital, Ho Chi Minh City) said that Ms. Pham Thi Nguyen (38 years old, Binh Duong) covered her head with a scarf and went to the hospital for examination at the end of May because she had a large tumor. When Ms. Nguyen took off her scarf, the doctors felt that the tumor was about to burst because it was so tense and had many blood vessels. The tumor growing on her head looked like a gourd, about 12 cm in diameter, with many necrotic hemorrhages on the surface. The patient was conscious and responsive.
MRI results showed that the tumor had spread through the skull to the meninges, approaching the superior sagittal sinus, causing skull bone destruction.
Large tumor on the patient's head before surgery. Photo: Tam Anh General Hospital
Doctors from the Department of Neurosurgery and the Plastic Surgery Unit consulted and performed a joint operation. The surgeons removed the entire tumor, reconstructed the damaged skull, and performed a cosmetic skin graft because if the wound was left open, there was a risk of brain and meningeal infection, which would have caused the patient to die more quickly.
First, the doctor cut out the entire tumor, leaving a 15x15 cm defect in the scalp below the lesion. The tumor that invaded the brain was completely removed and the skull was reconstructed with a titanium mesh. The surgery lasted 2 hours. After that, the surgical team grafted a cosmetic skin flap, taken from a vascularized skin flap on the thigh, to cover the skin and skull defect, which took more than 6 hours.
Dr. Che Dinh Nghia (Head of the Cosmetic Microsurgery Unit, Orthopedic Trauma Center, Tam Anh General Hospital, Ho Chi Minh City) said that this skin grafting is not like a normal skin graft (taking skin to cover the damaged skin area and that's it). The doctor must take both the skin and the blood vessels that nourish the skin, reconnecting small arteries and veins of one mm or less to pump blood, drain blood... to help the skin flap survive.
During the first 72 hours after surgery, doctors continuously monitor the grafted skin area for vascular occlusion, stable blood supply, etc. Patients are monitored for 7 days to assess the viable skin area. Dr. Nghia said that if the skin flap is defective, the blood supply is insufficient, and cannot survive, it will have to be treated, the skin grafted to reshape, the success rate is lower and the risk is higher.
After 4 days, the patient was conscious and the surgical wound was stable. The patient was discharged and returned for chemotherapy because this was a malignant tumor.
According to her 2004 medical record, Ms. Nguyen had a tumor on her head, a sarcoma (a malignant tumor of the soft tissue of the skin). She underwent surgery, radiation therapy, chemotherapy, and responded to treatment, but still had a skin defect. In 2009, she went to a large hospital to rotate a skin flap to cover the defect.
Then, the Covid-19 pandemic intensified, the tumor relapsed and grew rapidly and severely. The patient could not go to the doctor. After the pandemic ended, the patient went to Singapore for treatment, then returned home to continue treatment with both Eastern and Western medicine but did not respond. The tumor grew rapidly, hemorrhaged, necrotic on the skin surface, causing skull bone destruction.
Peaceful
* Patient name has been changed.
| In order to update the latest information on brain tumor surgery and cerebral hemorrhage stroke using the Modus V Synaptive robot with artificial intelligence, the only one in Vietnam, Tam Anh General Hospital System organizes an online consultation week on VnExpress newspaper. The program takes place from June 8-14, readers can follow and ask questions here to get answers from doctors. |
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