A 50 years old patient suffering from a rare cancer that developed a large mass of tumor around his chest bone was helped with the 3D printed custom-made titanium implant
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Sohail Akhter (name changed), 50, of Bangladesh, was suffering from a rare and difficult form of cancer in which a big mass of tumor impacted his chest bone (sternum), including the first eight ribs on both the left and right sides.
The tumor also affected the pericardium, which is the outer membrane of the heart and lungs. He traveled from nation to country, from one cancer center to the next, only to be denied since there was no feasible cure to his illness. The situation was complicated because, even if the cancer was removed surgically, there was no viable option to repair the chest bone (sternum) and ribs, which were required for regular breathing. Without it, the patient would be chronically reliant on mechanical ventilation.
When the patient came to Manipal Hospitals, the oncologist team of Dr Somashekhar S P, Dr Rohit Kumar C, and Dr Ashwin Rajagopal examined him and conducted a collaborative conference with the plastic surgeons, Dr Ashok B C, Dr Srikanth V, and Dr Anantheshwar, to treat this difficult case and preserve his life.
History of the Patient
The patient had a 6-year history of swelling in front of the chest with no symptoms of shortness of breath or palpitations. He was carefully treated in Bangladesh six years ago. When the swelling in his front chest reappeared, he traveled to India for more therapy.
Diagnosis and medical examination
His biopsy results indicated a cancerous tumor.
An MRI of the chest revealed a tumor mass of around 1512.7 cm that was resting on the lung and heart and had entirely destroyed the whole length of the sternum, or chest bone (sternum is the long flat bone present at the centre of the chest that connects the ribs to form the ribcage). The tumor was indenting the heart and expanding into the retrosternal region (within the ribcage). The mass was expanding anteriorly to the subcutaneous cavity (the lowest layer of skin) and displacing the muscles of the chest wall surrounding it, as well as laterally bulging in the muscle planes.
Tumor excision and sternum rebuilding surgery are used to treat this condition.
He had tumor removal surgery under general anaesthetic after providing informed permission and undergoing a complete preoperative assessment. Without significant blood loss, the whole chest bone (sternum) and ribs were removed. Following tumor removal, an advanced 3D printed custom-made titanium implant was used to restore the complete sternum and all of the ribs on either side. A novel drilling method and titanium wire were used to secure the new implant. The implant was a duplicate of the original chest bone and ribs removed during surgery. It was created prior to surgery using CT scan scans of the patient’s sternum and ribcages as well as 3D printing technology.
Dr. Somashekhar SP, Chairman & HOD–Surgical Oncology, Manipal Comprehensive Cancer Center, Manipal Hospitals, Bangalore, elaborated on this new technology, saying, “The entire chest bone (sternum) and the costosternal junction were printed with titanium powder, and a new titanium chest bone (sternum) was formed, custom-made for this patient based on his size, height, weight, and the portion of the skeleton to be removed.” For this, many discussions were held with the company’s technologists, engineers, and the Manipal oncology and plastic surgery teams. However, such implants are often exceedingly hefty, weighing up to 5 kg. This would be too hefty for the sufferer to hold on the chest in this instance. In order to correct this, a modified honeycomb method was employed to create the chest bone (sternum) and sternum weighing 250 grams.”
“Such implants are sturdy, long-lasting, and low in weight.” Furthermore, they are well-accepted by the body and are less likely to cause immunological responses or implant rejection. Such implants lower the risk of osteoporosis and fractures around the implant, which can occur as a result of unequal stress transmission between the implant and the surrounding bone tissue. “The implant was covered with muscle flaps removed from the front of the chest before sealing the skin,” explained Dr Ashok B C, Consultant – Plastic, Reconstructive, and Cosmetic Surgery, Manipal Hospital, Old Airport Road.
Patient recuperation and discharge
The patient healed quickly and was discharged from the ICU on the third post-surgery day. He began with chest physiotherapy and progressively became mobile. He was eating, breathing, and walking properly when he was discharged from the hospital, with no difficulties. He went back to living a regular, healthy life.
“Today, advanced technology may be employed to provide therapy in challenging cancer situations that were previously regarded to be incurable by many.” The credit for this case goes to “Excellent coordination between Manipal Comprehensive Cancer Centre and Dept. of Plastic and Reconstructive Surgery, which boasts modern technology combined with experts in the field of medicine, offering hope to millions of cancer patients worldwide,” said Dr. Somashekhar SP.
“New generation technology and materials are assisting patients with difficult challenges in solving and recovering quickly.” “This patient is a fantastic illustration of good medical care and technology coming together,” Dr Ashok B C stated.
Manipal Hospitals, a healthcare pioneer, is one of India’s major healthcare providers, servicing over 4 million patients every year. Its primary goal is to create a cheap, high-quality healthcare framework through its multispecialty and tertiary care delivery spectrum, and to expand it to out-of-hospital care.
With the acquisition of a 100 percent stake in Columbia Asia Hospitals Private Limited and Vikram Hospital (Bengaluru) Private Limited, the integrated network now has a pan-India footprint of 27 hospitals across 15 cities, 7,600+ beds, a talented pool of 4,000 doctors, and an employee strength of over 11,000 people.
Manipal Hospitals delivers comprehensive curative and preventative treatment to patients from all over the world. Manipal Facilities is NABH and AAHRPP accredited, and the majority of its hospitals are NABL, ER, Blood Bank accredited, and recognized for Nursing Excellence. Through numerous customer polls, Manipal Hospitals has also been named the most regarded and patient-recommended hospital in India.
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