Surgeons cut peach-sized tumour from baby in mother’s womb
Surgeons have revealed how they saved the life of a foetus by removing a peach-sized tumour from her mouth at just 21 weeks gestation.
In the first operation of its kind, experts at the University of Miami Jackson Memorial Hospital, in Florida, rescued Tammy Gonzalez’s pregnancy using instruments, including a laser, inside her womb. A hollow needle, passed through the uterus and into the amniotic sac, was used as a gateway through which surgeons passed narrow tools to assess and then cut away the tumour, which threatened to kill Leyna Gonzalez before she was born.
‘‘This is a world first, because basically nobody would have even thought about doing it before. It is a very rare condition and an even rarer solution,’’ Dr Ruben Quintero said.
The operation was carried out 20 months ago but has only just been revealed because surgeons had to wait to publish their work first, in line with scientific protocol, in the American Journal of Obstetrics & Gynaecology.
Quintero and his wife, fellow surgeon Eftichia Kontopoulos, performed the operation. ‘‘We think the world of them. They are her saviours,’’ said Gonzalez, 39.
She and her husband, Alain, 38, chose the name Leyna because it meant ‘‘little angel’’. Gonzalez’s pregnancy had progressed normally until 17 weeks when, one week after an ultrasound showed her that everything was fine, a second routine scan showed a rapidly-growing tumour emanating from the foetus’s mouth.
‘‘It’s the most
horrible feeling you could ever imagine, physically, emotionally, mentally,’’ she said. ‘‘I said, ‘What is this?’ Nobody could really give me an answer because it’s so rare. They told me what my options were and they weren’t good. I thought there has to be a way to save her. There was a lot of hoping, a lot of prayers.’’
She was referred to the Foetal Therapy Centre at the Florida hospital, where Quintero is a world-renowned pioneer in foetal medicine.
Leyna’s condition, a foetal oral teratoma, occurs in about one in 100,000 pregnancies. ‘‘At Jackson we would have to wait about 20 years to see one tumour like this,’’ Quintero said. ‘‘The concern with these tumours is that they can grow very rapidly,’’ he explained, resulting in fatal bleeding in the baby and miscarriage. The few babies that make it through to delivery require an emergency tracheotomy and multiple operations.
Gonzalez was told before being referred to Quintero that terminating her pregnancy was one option that she should consider. She was given a local anaesthetic and remained conscious throughout the hour-long operation, watching on an ultrasound screen as surgeons manoeuvred instruments with a precision measured in fractions of millimetres.
‘‘It was amazing,’’ she recalled. ‘‘ When they finally severed the tumour and I saw it float away, it was like this huge weight had been lifted off me and I could finally see her face – and it was perfect.’’
Leyna was born five months later, weighing eight pounds and one ounce. The only clue to her surgery is a barely discernible scar on her mouth.