Hyderabad: A multidisciplinary team at Kamineni Hospitals, King Koti, successfully completed an eight-hour clavicular tumour surgery on a 62-year-old man. The procedure removed a large tumour arising from the medial end of his clavicle.
The patient, Nagaiah from Kothagudem, was admitted on September 9 with severe breathlessness and facial swelling. Medical investigations found that the tumour had extended into his neck and mediastinum.
Doctors found the mass compressing the trachea and several major blood vessels. These included the aortic arch, right brachiocephalic artery, left subclavian artery and left common carotid artery.
Investigations also detected an enlarged thymus, which doctors suspected could be a thymoma. Given the tumour’s extent and pressure on vital structures, a multidisciplinary team decided to proceed with surgical removal.
The operation took place on September 16. Dr Musunooru Ravi Kiran, Consultant Cardiothoracic and Vascular Surgeon, Dr Shiva Kumar Reddy, Surgical Oncologist, and Dr Sandeep Sriram, Orthopaedic Surgeon, performed the procedure.
The surgical team removed the clavicular mass along with the enlarged thymus. The procedure also included repair of the left subclavian artery, flexible bronchoscopy and left sternocleidomastoid muscle plasty.
Doctors additionally performed a tracheostomy during the complex procedure. They carefully separated the tumour from surrounding vital structures and completely removed the mass.
Both phrenic nerves were preserved during the operation. The team also faced a significant airway challenge because the tumour had severely compressed the patient’s trachea.
Clavicular tumour surgery required airway management
Dr Chaitanya, Anaesthesiologist, and Dr Rakesh, Interventional Pulmonologist, secured the airway using bronchoscopy-guided intubation. The approach was used to safely manage the severe airway compression during surgery.
Following the operation, doctors shifted Nagaiah to the intensive care unit in stable condition. He subsequently recovered well and was being discharged in stable condition.
The hospital sent the excised tissue for histopathological examination. The examination will determine whether the patient requires further treatment, including chemotherapy or radiotherapy.
The case involved multiple surgical and medical specialists because the tumour extended beyond the clavicular region. The operation addressed the mass, affected blood vessels, airway compression and the enlarged thymus.
Doctors also preserved both phrenic nerves while separating the tumour from vital surrounding structures. The patient remained stable after the eight-hour procedure and recovered before discharge.