A team from UMBAL Burgas removed a huge tumor from the abdomen of a 60-year-old Burgas woman. The case has been a challenge for doctors from the very beginning. But what happens… Dr. Borislav Penev, a doctor at the Second Surgical Department of UMBAL Burgas, spoke to FACT.
- Dr. Penev, you recently had a rather challenging case in which you removed a tumor weighing 2 kilograms from the abdomen of a 60-year-old Burgas woman. The path is from abdominal discomfort to a complex operation. Tell us more?
- The case was really challenging. The woman came to us with severe abdominal pain. Initially, the symptoms pointed to appendicitis – something we often see. But I suspected that something was wrong. I assumed that there might be a tumor formation. I consulted a more experienced colleague, his opinion was the same. After the examinations, we found a huge tumor formation in the abdominal cavity - 10 cm in diameter and about 20 cm long. The tumor originated from the ovary. We had to quickly organize the operation. Fortunately, the intervention was successful and the patient recovered well. During the operation, we removed the tumor - it weighed almost 2 kg.
- The woman did not suspect its existence, although she had gained weight. How does such a tumor develop in a person's body?
- This is the insidious thing about such formations. They can grow slowly and for a long time not give clear symptoms. The abdominal cavity allows the tumor to gradually increase. In this case, the patient perceived the enlargement of the abdomen as weight gain, especially since she did not restrict her diet. She did not assume that there was a medical problem.
- It all started with abdominal pain, but what next?
- It follows that she sought medical help in time. And it is good that she did. Then came examinations and imaging studies to show what the cause was. In this case, the scan was decisive because it gave us a clear picture of the scale of the problem and allowed us to plan the operation carefully.
- Such a large tumor formation compresses internal organs. Abdominal pain is one thing, but what else could have happened?
- At such a size, the tumor can compress the intestines, bladder and even large blood vessels. This can lead to digestive problems, constipation, and difficulty urinating. There is also a risk of ovarian torsion, which causes extremely severe pain and requires emergency surgery. If the condition is ignored, complications can be serious.
- What was the challenge during the operation for the doctors - in terms of the ovary and internal organs?
- When the tumor is so large, the internal organs are displaced from their normal position. This requires very careful work to avoid injuries. The most important thing was to remove the formation completely without harming the patient. Since the origin of the tumor was not clear beforehand, during the operation we called a colleague - an obstetrician-gynecologist, who consulted throughout the operation. Our hospital is large, this is a great advantage, as we have a multidisciplinary team available and can react quickly.
- Histology shows that the tumor is benign. What determines whether a tumor will be benign or malignant?
- This depends on the characteristics of the cells themselves - how they look and how they divide. Benign tumors usually grow more slowly and do not spread to other organs. Malignant tumors have the ability to invade surrounding tissues and give out metastases. However, the only sure answer comes after a histological examination.
- When it comes to tumors, doctors always ask: “Is there a permanent change in weight?“ Why is this question among the first?
- Because any unexplained and permanent change in weight can be a signal that something in the body is changing. In this case, the increase in the abdomen was perceived as weight gain. That is why we ask – to determine whether there is a trend that requires additional research.
- How early could a routine gynecological examination detect a tumor?
- With regular preventive examinations and ultrasound, such a formation can be detected much earlier, even at a significantly smaller size. This makes treatment easier and reduces risks. Therefore, our advice to women is not to miss annual gynecological examinations – sometimes they prevent serious complications.