In a breakthrough surgery, U.S. doctors removed rare spinal tumor through a patient's eye socket

A surgery performed on a person's spine requires attention to minute details. It holds a majority of the body anatomy and surgeries or injuries to this part can cause several complications, per the Regenerative Spine and Joint Center. However, for 19-year-old Karla Flores, doctors wondered what they could do to get rid of a spinal tumor, per The Washington Post. Mohamed A.M. Labib, a UMMC neurosurgeon and assistant professor of Neurosurgery at the University of Maryland School of Medicine (UMSOM) and lead surgeon in Flores' case, took a rare pathway to get this tumor out and it turned out to be one-of-a-kind surgery.  

Flores had previously undergone two surgeries at the University of Maryland Medical Center to get rid of a rare and large tumor in her brain. They also discovered a smaller one near the base of her skull. "The tumor was wrapped around the patient's spine and spinal cord and had invaded the vertebrae in her neck, just below the base of the skull," the surgeon said, per Medical Express. It was a rare tumor called a chordoma, a malignant growth that was pressing against her left eye, causing trouble with vision. Around 300 cases similar to Flores’ are diagnosed in the U.S. each year. Spinal issues are often complicated and have to be dealt with carefully.

Any mishaps could lead to nerve damage, internal bleeding, blood clots or other medical complications. In the case of Flores, if the surgery had gone wrong, she would have lost all movement below her neck or suffered a fatal brain-stem stroke. The surgeons decided to try a rare step — removing the tumor through the woman’s left eye socket. It was a massive step that could have brutal repercussions or lead to a ground-breaking impact on modern surgery. Labib took to prayer before he could use his skill to perform a life-changing operation. “I am only a tool in the hands of God,” he said. The neurosurgeon has been taking on unusual cases since 2021. 

One of these included the rescue of a patient with five brain aneurysms. In the case of Flores, he was taken back to his mechanism to approach “inoperable cases.” “Fear should ignite in us the motivation to try and understand: Why are we not able to do these cases?” he said. He added that just pondering the question can often reveal insightful answers. The chordoma in Flores’ spinal area posed complications. The doctors couldn’t blast it, for fear of it growing back, nor could they remove it from behind, as there was only limited potential and an obstructed view.

Removing it from the mouth could lead to an infection and the option remaining was what Labib called the “third nostril” — the left eye socket. After much pondering and decision-making, the family and surgeon went ahead with the procedure. Together with Andrea Hebert, who worked on Flores’ previous surgeries, and Kalpesh Vakharia, who helped track the possibility of this unique pathway, the team was hands-on. A strenuous and unimaginable procedure lasted from afternoon to late evening and after 19 hours, the tumor was finally gone. Flores had to follow up with another minor surgery to add rods and screws to stabilize the base of the skull and the spinal cord.

What followed was a month of recovery and then some more rest at home. This month marks a year since the woman’s surgery and her neck is still in slight pain. She wears a bone therapy collar to support her neck and limit movement, but the good news is that all traces of the tumor are gone. “I am happy that through a very coordinated multidisciplinary team effort, she had such a successful outcome,” Labib noted.