Every so often, while growing up in Kenya, my dad used to describe a "case of the week" while we were all eating dinner. Sometimes these were mysterious diagnoses (like The Rift Valley Hemorrhagic Fever), and sometimes they were just interesting stories or demonstrations of how resilient patients were (like the Maasai warriors who were bitten by a lion). Thus the inspiration for our own upcoming blog series: The Case of the Week. Many of these will likely contain pictures not intended for those with especially weak stomachs (this week included). Consider yourself warned. If you are extremely queasy, beware of blog posts entitled "The Case of the Week." And of course we intend to protect patient privacy as necessary.
This case was a teenage boy who presented looking at least 9 months pregnant. Since his abdomen was as tight as a drum from this mass which had been growing over the past year, we decided to operate. We intended either to take out the whole tumor or at least to get a piece of it for pathology. The boy actually had no significant symptoms and no other findings on exam. At the time of the operation, we found that this mass was decently circumscribed, and so we proceeded with totally excising the whole thing. It was attached to the stomach, liver, diaphragm, and transverse colon, so we had to remove a piece from each of those. By the end we could see that the tumor originated from the spleen. Thanks to God's grace, and the help of one of our excellent residents, we successfully removed this 25 lb tumor. The pathology showed it to be a malignant lymphoma. I have never before removed 20 percent of someone's body weight in a single operation. The patient is quite pleased with this Fader Weight Loss Plan.