HeYou Hospital Performs a High-Difficulty Surgery to Remove a Rare Giant Liver Tumor in a Septuagenarian Patient

The mere mention of cancer often evokes fear, with many associating it with negative terms like “difficult to treat” and “poor prognosis.” In reality, however, with exceptional medical expertise, many complex diseases can be overcome.

Recently, at HeYou Hospital, a 73-year-old tumor patient suffering from multiple complex diseases had a giant tumor completely removed under the support of a multidisciplinary team. She has since recovered and been discharged. “The elderly lady lost over 10 jin in the two months before surgery, but gained 3 jin just one week after the operation. The surgery was a great success, and we are very satisfied,” her family members expressed.

Patient Grandma Zhou (pseudonym) had experienced an unexplained loss of appetite over the past two months. A recent examination at a local hospital revealed a space-occupying lesion in the right lobe of the liver. Additionally, a low-density small nodule was found in segment S7 of the liver, leading doctors to suspect a high probability of intrahepatic metastasis.

Grandma Zhou's family visited several hospitals. Due to her advanced age and complex condition, doctors expressed limited confidence in the surgical prognosis. Recently, upon a friend's recommendation, Grandma Zhou's family came to the General Surgery Department of HeYou Hospital seeking help.

 Upon admission, the General Surgery Department promptly completed all examinations. MRI plain scan + contrast enhancement indicated a space-occupying lesion in the right lobe of the liver measuring 11cm x 10.6cm x 7.6cm, suspected to be malignant. Considering Grandma Zhou's medical history, symptoms, signs, and relevant auxiliary examination results, a diagnosis of gastrointestinal stromal tumor (GIST) with liver metastasis was considered highly likely,and surgery was identified as the only potentially curative option.

However, the challenge was that Grandma Zhou had a 30-year history of hypertension, which was poorly controlled, with readings reaching as high as 200/90 mmHg; a history of diabetes for over ten years, without standardized medication; and she also suffered from paroxysmal atrial fibrillation, acute or chronic multiple lacunar cerebral infarctions, and other chronic diseases. The surgical risk was extremely high, and surgical safety was the primary concern for everyone involved.

Image showing the location and size of the tumor

Considering the patient's advanced age and poor surgical tolerance, along with the large size of the liver tumor, procedures such as liver tissue resection, vascular ligation, and reconstruction could lead to intraoperative bleeding, postoperative infection, and liver failure. Furthermore, the patient's comorbidities of hypertension, diabetes, and cardiac and cerebral diseases necessitated careful management of anesthesia risks, bleeding risks, and postoperative infection risks. These were all potential challenges that the surgery might encounter. On the other hand, without timely surgery, her life was at risk at any moment.

Given the complexity of Grandma Zhou's condition, the hospital organized multiple MDT consultations involving the General Surgery, Neurology, Cardiology, Anesthesiology, ICU, Clinical Nutrition, Endocrinology departments, and the Nursing Department.

“We came to HeYou Hospital because we trust the medical expertise here. The meticulous examinations and comprehensive evaluations during these days of hospitalization have further strengthened our confidence.” With the family's support, two days later, the General Surgery Department performed a liver lesion resection on Grandma Zhou. The surgery lasted 4 hours and completely removed a tumor approximately 11.0 cm in diameter. Postoperative pathology confirmed it as a gastrointestinal stromal tumor with liver metastasis.

“Throughout the perioperative period, to ensure surgical safety, our multidisciplinary team conducted multiple rounds of consultations and developed a comprehensive, detailed plan. It can be said that the success of the surgery was inseparable from the close and efficient collaboration of multiple disciplines,” stated Professor Li Jun, Director of the General Surgery Department.

On the 4th day after surgery, Grandma Zhou was transferred from the ICU to a general ward. Two weeks later, she recovered and was discharged, specifically presenting a banner and a bouquet of flowers. “The director, doctors, nurses, and nursing assistants all took excellent care of the elderly lady. We felt very at ease during her hospitalization here!” Grandma Zhou's family expressed their profound gratitude.

Gastrointestinal stromal tumor (GIST) is a rare tumor originating from the interstitial cells of the digestive tract, which are responsible for regulating intestinal muscle activity. GIST can occur anywhere in the digestive tract but is most commonly found in the stomach and small intestine. They typically grow slowly but can sometimes become aggressive and metastasize to other organs. The liver is the most common site of GIST metastasis.

Director Li Jun explained that GIST typically has no obvious symptoms in its early stages. However, as the tumor grows, patients may experience symptoms such as abdominal pain, indigestion, nausea, vomiting, or weight loss. If these symptoms occur, especially when accompanied by discomfort in the liver area, it is recommended to seek immediate medical attention.

Current main treatment methods for GIST and its liver metastases include:

Currently, the main treatment methods for GIST and its liver metastases include:

Surgical resection is the primary treatment for localized GIST. For GIST with liver metastasis, if the conditions permit, simultaneous resection of the primary tumor and liver metastases can be performed. For patients who cannot undergo surgery, targeted drug therapy (such as imatinib) can be used to control tumor growth. Additionally, interventional treatments like hepatic artery chemoembolization or radiofrequency ablation can be employed for liver metastases.

Director Li Jun reminds everyone that regular health check-ups are crucial for the early detection of GIST. For high-risk groups, such as those with a family history of GIST or related genetic syndromes, more frequent screening is recommended. If any suspicious symptoms are identified, it is important to seek medical attention promptly and undergo relevant examinations, including gastroscopy, colonoscopy, and imaging studies, to facilitate early diagnosis and treatment.