A tumor is a challenging diagnosis, and things can become even more challenging when wrongly interpreted, treatment delayed, or the treatment received is irrelevant to the condition. In 2018, Sampath, a 47-year-old from Bangalore started having frequent episodes of weakness and bone pain along with walking difficulties. Little did Sampath know that his symptoms were pointing towards something more than an orthopaedic issue.
For the next one and a half year, Sampath had a series of misdiagnoses at a couple of hospitals and clinics in Bangalore, where he was treated for ankylosing spondylitis – a type of arthritis. However, he showed no response to the treatment. Throughout this time, Sampath suffered from multiple fractures, severe pain, and could not walk without a walker. He also had low levels of calcium, phosphates, and vitamin D, which only aggravated his mobility problems. At one point, neither did the medicines nor the injections helped solve his medical problems. The worst part about his condition, was that none of his doctors were able to figure out what was causing all these problems.
Remembering those times of uncertainty, Sampath says that whenever he took a pill or got an injection, he hoped that it worked, because the pain turned out to be unbearable day by day. Very soon, Sampath was left with no choice but to stop working. Being the sole breadwinner for his family, he went through some very tough times. He continued with the treatment hoping it would start working soon. It was during this time in July 2020 that Sampath was directed to HCG Cancer Hospital, Bengaluru for one of his PET CT scans. This scan showed a rare tumor in his nasal area. It did not take much time for the expert team at HCG to decide that most of Sampath’s problems were linked to this tumor.
The head and neck expert team at HCG Cancer Hospital, which consists of eminent doctors like Dr. Gaurav Medikeri, Dr. Vishal Rao and others, took this challenging case with the hope of giving Sampath a new lease of life. Sampath was not expecting a tumor diagnosis; nevertheless, he finally knew what he had. Dr. Gaurav spoke to him and explained on how the nasal tumor was causing all his problems and how it could be treated successfully with a surgery. After a really long time, Sampath had heard something hopeful, and this time, it was not a false hope.
According to Dr. Gaurav Medikeri, Program Director of Endoscopic Skull Base Surgery, HCG Cancer Hospital Bengaluru, the tumor in Sampath’s nose, which is technically called a sinonasal phosphaturic mesenchymal tumor, was secreting a hormone known as fibroblast growth factor 23 or FGF 23, which systematically lowers the levels of calcium, phosphates, and vitamin D – all of which are necessary for bone health management. He also says that there are only around 17 cases of this condition recorded throughout the world.
The expert team decided on proceeding with a minimally invasive surgery involving endoscopy, instead of an open surgery. His tumor had eroded the bone between his nose and eye and was stuck to the muscles of his eyeball, making the case ever more challenging. The tumor was vascular which meant that it had to be handled with care, if not it would bleed into the eye, possibly leaving him blind. With the help of advanced equipment such as a high definition camera system and endoscopes, the tumor was gently peeled off his eye muscles without damaging them and removed through Sampath’s nose uneventfully.
Dr. Gaurav Medikeri also adds that opting for an endoscopic minimally invasive surgery has several advantages such as better visualisation of the tumor, faster recovery, few side effects, reduced scarring, quicker return to normal life, reduced hospital stay and minimal damage to the surrounding tissues. In Sampath’s case, it led to a drastic improvement in his quality of life. The very next day, Sampath’s pain scores had come to an all-time low. After been crippled for almost two years, the last thing Sampath wanted was another open surgery that needs a longer recovery period. Today, he is tumor-free, does not use a walker and he is now back to work with a smile.
With this successful treatment and almost immediate recovery, Sampath’s joy knows no bounds. 2 years of pain and misery is now over. Thanking the doctors at HCG, Sampath says that it was the specialists at HCG that diagnosed his condition correctly, treated it successfully, and most importantly, gave him his old life back. He also adds that he is eternally thankful to Dr. Gaurav Medikeri and Dr. Vishal Rao, who, from the beginning were positive and hopeful about his condition, and this made him stay positive throughout the treatment.
“If it were not for Dr. Gaurav Medikeri, and the team of doctors at HCG, there would have been no chance I would get the right diagnosis, let alone getting the correct treatment,” Sampath concludes.
A tumor misdiagnosis is neither unusual nor rare. In many cases, the symptoms of a tumor may be missed for days, weeks or even months, before the doctors consider it as one of the possibilities. In cases like these, it is always better for the patients to opt for a second opinion, especially when the recommended treatment is showing no response. A second opinion helps both the physicians and the patients make informed clinical decisions, which are crucial for successful tumor management.
