Kolkata :Narayana Superspeciality Hospital, Howrah emerging as one of the leading tertiary care facilities in Eastern India has announced that it had successfully cured a 45 year old woman from Jalpaiguri of a rare disease called Evans Tumour. This was possible only due to the right diagnosis done by doctors at Narayana Superspeciality Hospital as the lady was earlier misdiagnosed thrice at other hospitals.
Evans Tumor also known as low-grade fibromyxoid sarcoma (LGFMS) was first described by Harry Evans in 1987. A sarcoma is a malignant tumor of connective or non-epithelial tissues which is in contrast to a carcinoma which is a malignant tumor originating from epithelial cells. While human sarcomas are quite rare, common malignancies, such as breast, colon, and lung cancer are almost always carcinoma.
Dr. Kousik Nandy, Consultant, Orthopaedic-Oncologist, Narayana Superspeciality Hospital, Howrahsaid, “This case was one of the very rare ones I have come across. Evans Tumor is a very rare and low-grade tumor usually found in the central part of the human body; whereas Pushpa was found to have a high-grade tumor in the arm, which made diagnosis a huge challenge’’,
Pushpa Singh, a matron from Sukna, Jalpaiguri was first operated on her left elbow in 2011 with a diagnosis of bone cyst in the humerus. (A bone cyst is a fluid-filled hole that develops inside a bone and humerus is the long bone in the arm that runs from the shoulder to the elbow.)
After the first operation she developed a pathologic fracture in the humerus. (A pathologic fracture is a bone fracture caused by disease like bone cyst that leads to weakening of the bone structure.)
Pushpa then got operated for the pathologic fracture. This time she developed Fibrous Dysplasia of the humerus. (Fibrous Dysplasia is a bone disorder in which scar-like (fibrous) tissue develops in place of normal bone.)
Pushpa then proceeded to the Operating Theatre for the third time where she underwent Fibula Autografting. (In other words, tissue from the fibula or the calf bone was transplanted to the humerus.)
The next one year for Pushpa went by normally until she developed a huge swelling on her left elbow. Pushpa then visited Narayana Superspeciality Hospital, Howrah for further medical advice. An MRI test was done on Pushpa which did not reveal much information, but clinically, she appeared to have an aggressive tumour. Then a biopsy and immunohistochemistry test was done on Pushpa which surprisingly showed no evidence of malignancy. After extensive discussion in the multidisciplinary Tumor Board, it was decided to treat her in the line of low-grade fibromyxoid sarcoma (Evans Tumor).
Dr. Kousik Nandy, Consultant, Ortho-Oncologist & Dr. Adhish Basu, Consultant, Plastic Surgeon decided to perform an excision (removal) of the tumor which was stuck to the bone. Further tests showed that the tumor was indeed malignant. After a bone resection and total elbow replacement, skeletal reconstruction was achieved. And as the skin and muscles that flex the elbow had been removed, flexibility in the elbow was restored after taking a muscle from the back (Latissimus Dorsi muscle).
Dr. Adhish Basu, Consultant, Plastic Surgeon, Narayana Superspeciality Hospital, Howrah said, “We used one of the most advanced reconstructive surgery methods in the replacement of the humerus bone, elbow, flexor muscles and skin of the elbow to give back Pushpa a normal arm”
Pushpa is now fit and currently on a rehabilitation program for muscle strengthening exercises.
Akshay Oleti, Facility Director, Narayana Superspeciality Hospital, Howrah said, “Our focus at Narayana is to achieve excellence in what we do and are proud to say that Narayana Superspeciality Hospital, Howrah is the only hospital in East India offering Ortho-Oncology treatment. The efforts of Dr. Nandy and Dr. Basu have ensured that Pushpa can now lead a normal life”