PGIMER Chandigarh doctors endoscopically remove brain tumour from 16-month-old girl

Doctors at Post Graduate Institute of Medical Education and Research claim to have removed a large brain tumour through the nose from the world’s “youngest-ever patient”.

The girl, aged 16 months, was referred to PGIMER from Uttarakhand, with loss of vision.

“The child was normal and playful a few months back. For the last 20 days, her mother noticed that she was not following anything shown to her. The child’s MRI revealed a calcified brain tumour at the base of the skull, suggestive of craniopharyngioma of size 3cm, large for a child of one year, close to critical neural structures, such as optic nerves and hypothalamus,” PGIMER stated in a release.

“These tumours are usually operated on through open surgery and the remaining part is treated with radiation therapy. Over the last few years, such tumours are being removed through the nose endoscopically by neurosurgeons teaming with ENT surgeons among patients older than six years. However, endoscopic removal through the nose is highly challenging in small children because of small nostrils, immature bones at the skull base and proximity to crucial blood vessels,” the release added.

The operation was conducted by a team of endoscopic skull base surgeons, including Dr Dhandapani SS and Dr Sushant from the department of neurosurgery, and Dr Rijuneeta from the department of ENT.

“The youngest child reported to date having undergone endoscopic surgery through the nose for such tumours was 2 years old, operated at Stanford, USA, in 2019,” PGIMER said.

On how the operation was conducted, doctors said extensive drilling of the immature bones was carried out using a diamond drill and computer navigation, and a tumour-removal corridor was created. The tumour was dissected from critical structures using angled endoscopes and removed through the nose despite very little working space.

After a six-hour-long surgery, the child was moved to the ICU and recovered well. After 10 days of surgery, she has improved vision and no complications, with a CT scan showing almost complete removal, doctors said.