The Telegraph
Wednesday , January 22 , 2014
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Siddika recovers after 7-hour surgery

New Delhi, Jan. 21: Siddika Pervin sipped milk in the intensive care unit at AIIMS on Sunday as she recovered from surgery that extracted a tumour from near the base of her brain that had made her grow over seven feet tall and weigh 160kg.

The tumour is almost gone, but she won’t lose her title of one of the world’s tallest women. Surgeons at AIIMS who removed the tumour after a seven-hour procedure on Thursday described the operation as “challenging” and said she could lose weight but not her height.

“She’s recovering, she drank a bit of milk today and sat on a chair for a few minutes,” a nursing assistant who identified herself as Bikhi Dey said on Sunday. Siddika’s father Afasuddin Ahmed said she was looking forward to going home.

Doctors believe Siddika was brought in the nick of time for surgery. She had a tumour called a pituitary adenoma that leads to abnormal secretion of the growth hormone causing people to gain height and weight far beyond average levels. “The tumour was pressing the optic nerve, she could have gone blind in 30 days,” said Ashish Suri, additional professor of neurosurgery at AIIMS who led the surgical team. “The adenoma could also have caused a life-threatening condition called hydrocephalus in the brain.”

Doctors suspect the pituitary adenoma would have begun growing when Siddika, a resident of Buniadpur, about 60km from Balurghat in South Dinajpur, was in her early teens. Her family recalled that she began growing unusually fast after she had turned 10.

Her plight, doctors say, reflects India’s embarrassing reality of health care in rural areas where many patients do not receive timely treatment because of either poor diagnosis or inadequate access to appropriate treatment.

“She may not have grown so much if the surgery had been done earlier,” Suri said. Tests at AIIMS, where she was brought in November 2013, revealed that Siddika’s levels of growth hormone were nearly 16 times higher than the normal range.

The AIIMS neurosurgeons approached the pituitary adenoma through her nose, using fine endoscopic instruments with tiny cameras mounted on them to watch the operating field through a computer screen, then gently pulling out the tumour piece by piece.

Suri has performed nearly 9,000 brain surgeries over the past 20 years and routinely trains young surgeons in endoscopic neurosurgery, a procedure that helps surgeons avoid making large incisions on the skull. “But the surgery on Siddika was among the most challenging I’ve encountered,” he said.

The team removed 90 per cent of the 4cm tumour, leaving behind a tiny portion that Suri said could not be extracted because it was too close to important blood vessels. The residual tumour could be removed through radiotherapy or medication.

Siddika had received pre-operative medical management at the AIIMS endocrinology department and doctors say she will need to continue taking medicines after surgery. “She’ll require lifelong medical therapy to address certain hormone deficiencies caused by the destruction of the normal pituitary gland by the tumour,” said Nikhil Tandon, professor of endocrinology at AIIMS.

The South Dinajpur district Congress president, Nilanjan Roy, and a member of the All India Congress Committee, Om Prakash Mishra, helped the family by making arrangements for their visit to Delhi and the treatment at AIIMS.