After Complex Surgery at Bethesda Hospital East, She ‘Perfectly’ Defeats Rare, Aggressive Neck Tumor
3 min. read
Baptist Health Bethesda East Hospital
Carolyn Dias-Karch, 34, of Boynton Beach, helps recovering patients get back to independent, fully functioning lives as a physical therapist at Cornell Institute for Rehabilitation Medicine at Bethesda Hospital East.
Recently, on an otherwise normal workday, a colleague noticed a mass on Carolyn's neck. Recalls Carolyn: "I had a case manager walk into the room with me and a patient and we started talking, and she kindly took me aside and just said, 'Hey, you have something on your neck. You have a mass. I don't want to freak you out or anything.' But it was big enough for her to notice that I needed to get it checked out."
She didn't have to go far to get expert advice on what turned out to be a challenging diagnosis by surgeons at Bethesda Hospital East. What initially looked like a growth in her thyroid gland was actually much more complex and serious -- a very rare and aggressive tumor.
Indeed, Miguel Lopez-Viego, M.D., vascular surgeon at Bethesda Hospital East, confirmed that the growth involved the carotid artery, a vital blood vessel that provides the brain's blood supply. And there was more troubling news. Carolyn's tumor involved severely vital organs and structural elements. The tumor involved the carotid artery, the jugular vein and the vagus nerve in her neck, he said. It also extended "into her chest very close to her heart," he added.
The carotid artery and the internal jugular vein run side-by-side in the neck, one pair on the left and one on the right. The carotid carries oxygenated blood up to the head, while the jugular drains deoxygenated blood down to the heart.
The tumor that Carolyn presented with is called a solitary fibrous tumor. "It's basically a cancer of the head and neck, sometimes extending into the chest, that has variable rates of aggressiveness -- but is very difficult to manage, and it is an extremely rare tumor," explains Dr. Lopez-Viego. "There's only a handful of these tumors reported in the literature anywhere in the world. And no center has any significant experience with it. So, it was basically coming up with a clever solution to a difficult problem, and that's something that we're very good at here."
Surgery on such a tumor and its location potentially produces many serious complications, but Carolyn felt reassured by Dr. Lopez-Viego.
"I didn't know if it was going to be terminal or if I was even going to survive the surgery," she recalls. "But the first moment that I met Dr. Lopez-Viego, he sat right in front of me and he asked me about my life plans and wanted to get to know me. And he reassured me that this wasn't going to get in the way of any of those plans. And I got to breathe, finally, in that moment when he said that."
Before her surgery, Dr. Lopez-Viego discussed potential complications, including the possibility of stroke, a long-term disability related to the resection of this tumor, and the possibility that the tumor would be incompletely resected.
Despite the potential complications, the surgery went smoothly without any issues.
"Carolyn did perfectly," said Dr. Lopez-Viego. "The operation, which four surgeons participated on, was effective, the blood loss was minimal, there was not a single complication of all the lengthy complications that I had to think about for a month, and she literally left the hospital the day after the operation. And the final pathology report returned with clear margins and a successful operation."
Carolyn, who spends her days caring for others as a physical therapist, now finds herself deeply gratefully for her care at Bethesda Hospital East.
“Dr. Lopez-Viego came and visited me,” she said. “My parents were in the room and he informed me that everything went well -- that they were able to get the whole tumor out, that everything that could have gone right went right, and that I was going to be okay. He (Dr. Lopez-Viego) said, ‘I'm not going to let this girl live with this,’ and I want to thank him from the bottom of my heart for saving my life.”
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