When Dr Pham Dang Tinh, a specialist in Anaesthesiology and ICU, discovered a malignant tumour while his wife was over eight months pregnant, the prognosis was dire. Despite the urgency, he made the heartfelt decision to postpone surgery until after witnessing the birth of his child. What followed was nothing short of miraculous.

Shocked to Discover a Rare Large Tumour in his Early 30s

During a routine health check-up, Dr Pham Dang Tinh was unexpectedly diagnosed with a large tumour located in the left pelvic region. Concerned about the severity, he independently researched the condition and sought advice from medical experts across the country. Specialists unanimously agreed on the tumour’s critical nature, given its proximity to major blood vessels and nerves in the pelvic region. The restricted surgical access further compounded the risk, with  a significant chance of complications, as previous cases had tragically resulted in fatalities.

“At that moment, it felt like the world was crashing down on me. At the age of 31, I had everything I had hoped for: a good job at an international hospital, a small family, and was preparing to welcome our second child,” Dr Tinh reflects.

Faced with his own devastating diagnosis and the fact that his wife was eight months pregnant, Dr Tinh decided to keep the situation secret from his family and delay the surgery. He silently bore the worry for more than a month, until the healthy birth of his child. Only then did he inform his family, downplaying the seriousness of the surgery. He confided in his mother-in-law about the high-risk surgery, saying, “I trust my colleagues with my life. No matter what happens, please believe that they will do everything they can.”

Trusting My Colleagues With My Life

Through detailed assessment, the doctors identified the tumour was located outside the peritoneum on the left pelvic side, measuring 12x10x9cm. It extended from the L4-L5 lumbar vertebrae to the area near the prostate and anus. This solid tumour contained areas of calcification and was positioned against the left pelvic bone wall, pressing on the L4-L5 nerves and sacrum. The network of blood vessels in the left pelvic wall was compressed, pushing toward the right side, while the tumour displaced pelvic organs such as the rectum, bladder, and ureter to the right.

FV Hospital organised a multidisciplinary consultation, bringing together specialists from general surgery, neurosurgery, urology, radiology, and anaesthesiology, to meticulously plan the surgery for optimal effectiveness and safety. Dr Phan Van Thai, Specialist Levell II and Head of the General Surgery Department at FV Hospital, led the procedure with the objective of fully excising the tumour. The team aimed to minimise the risk of recurrence, preserve surrounding tissues, prevent complications such as incontinence, and reduce blood loss.

Given the lengthy procedure and high risk of bleeding, the surgical team carefully prepared blood products in advance, establishing a reliable transfusion line, and closely monitoring hemodynamics throughout the operation. “We treat Dr Tinh like family, and given the rarity of this tumour, we had to plan meticulously to ensure the best possible outcome,” shared Dr Nguyen Thi Lam Giang from the Anaesthesiology & ICU Department.

A Complex and Meticulous 12-Hour Surgical Procedure

On the morning of November 6th, Dr Tinh was taken into the operating room. Before receiving anaesthesia, he grasped the hand of each member of the surgical team, encouraging them to approach the procedure with calmness and confidence. He assured them that, no matter the outcome, he was at peace with his decision and placed his complete trust in their expertise to manage the situation.

Dr Tinh’s surgical team included four doctors, led by Dr Phan Van Thai, and four anaesthesiologists. During the operation, Dr Thai meticulously separated the blood vessels and  carefully extracted the tumour from the intricate vascular network of blood vessels, striving to preserve as much of the vascular system as possible. “In some areas, we had to dissect just millimetres at a time because if a blood vessel ruptured, there would be no space to control the bleeding. The only option would be to cut the tumour and stop the bleeding to save the patient, at that point the goal of completely removing the tumour to prevent recurrence would no longer matter,” Dr Thai explained.

During the tumour dissection, the surgeons discovered that the back left portion of the tumour had several nerve branches from the sciatic nerve integrated into its capsule. Dissecting these nerves would have meant leaving part of the tumour intact, almost certainly leading to recurrence. To ensure the complete removal, the surgical team made the difficult decision to excise the affected nerve branches, accepting the potential for weakness in certain muscle groups of the left leg. After 12 hours, the entire tumour was successfully removed. The team breathed a collective sigh of relief as the delicate nerves controlling the urinary and genital systems were meticulously preserved and no additional blood transfusions were required.

The tumour was sent for biopsy, which confirmed the final diagnosis was a schwannoma – a rare type of nerve sheath tumour. According to U.S. statistics, this type of pelvic tumour occurs in approximately 2.4 cases per million people.

“When I woke up, I was very happy to know the entire tumour had been removed, my bowel and bladder control were intact, and most importantly, I was still alive after such a major surgery,” Dr Tinh recalled. After the surgery, he continued with physical therapy and rehabilitation to address the weakness and numbness in his left leg.

What Dr Tinh endured was both an extraordinary challenge and a testament to the resilience of life. With his positive mindset, he is confident that he will soon return to his work at FV Hospital, ready to continue his life-saving work and honour the sacred mission he embraced when he chose a career in the medical profession.