Recently, a team of neurosurgeons from Hainan Cancer Hospital successfully removed a huge "chordoma" from the base of the skull of a woman.
Due to the patient having undergone three surgeries and three recurrences, the operation was complex, highly challenging and risky, and could be regarded as the "ceiling" of skull base tumors.
On August 6th, patient Ms. Xian was discharged from the hospital after recovery.
1. The tumor recurred three times after three surgeries. I sought treatment everywhere but in vain
Eight years ago, Ms. Xian, who was in her forties at that time, was diagnosed with a "chordoma" at the base of her skull due to headaches and vision loss at other hospitals in the province. She underwent surgery and radiotherapy.
Subsequently, in 2022 and 2024 respectively, the tumor recurred, causing blindness in the left eye and other issues. He made special trips to Beijing twice for surgical treatment.
In April this year, the tumor recurred again and grew rapidly to the size of a fist.
Ms. Xian and her family once again embarked on the journey off the island to seek medical treatment. Due to the complexity of the tumor and the high surgical risks, they sought medical help in many places but to no avail.
At the end of July, a fellow patient recommended to Ms. Xi: "There is a very capable expert in the neurosurgery department of Hainan Provincial Cancer Hospital. You can give it a try."
Ms. Xian came to the hainan cancer hospital with the last glimmer of hope.
2. The tumor is extremely complex and the surgical risk is huge
Zou Wenhui, the director of the Neurosurgery Department of Hainan Provincial Cancer Hospital, is the expert who is highly praised by patients as "very capable".
Zou Wenhui introduced that chondrosarcoma of the skull base is a rare malignant tumor with strong invasiveness, which is prone to invade surrounding tissues and bone structures, leading to local destruction.
Ms. Xian had a tumor at the base of her skull that required three surgeries. It protruded outward to the size of a fist on her face and orbit, eroded the base of her skull inward, and "wedged" into her cranial cavity.
Director Zou Wenhui studies patient cases (archive photo)
Experts assess that the surgery has "three risks": First, the anatomical structure of the skull base will change, making the operation extremely difficult. Second, there will be massive bleeding during the operation, which requires "precision, accuracy and speed", and places very high demands on the experts experience. Third, the tumor has eroded the skull base, making the operation complex and highly risky.
3. The operation was complex and meticulous, involving both removal and repair
Ms. Xians surgery for a tumor at the base of the skull was performed by Dr. Zou Wenhui.
Zou Wenhui is a typical "tech enthusiast". When dealing with complex tumors, he will study them repeatedly, even turning the computer screen around to ponder. Before the operation, he will carefully read the films, observing every detail and repeatedly simulating the surgical process and emergency response.
Patient safety comes first. Zou Wenhui and his team developed multiple detailed surgical plans for Ms. Xian and, like in a major battle, coordinated and communicated with teams such as the blood transfusion department and the anesthesiology department repeatedly before the operation.
The team doctor gave a blessing and introduction. The surgery was far more difficult than expected. The tumor not only invaded the intracranial cavity but also eroded the internal carotid artery. The slightest mistake could threaten the patients life.
Difficulty Level One | Disassemble
To ensure the complete removal of the tumor and reduce the risk of recurrence, Zou Wenhui made a surgical "window" on the patients forehead. With the aid of a high-power neurosurgical microscope, he carefully separated the tumor from the arterial vessels and then precisely and quickly removed the tumor bit by bit that was entangled in the normal tissues.
The blood supply to the tumor is particularly abundant. After the tumor was removed, the blood in the tumor bed gushed out like a sand pipe burst, making a gurgling sound. Fortunately, there was a contingency plan in place, and the situation was handled without incident.
Level Two | Supplementary
It is relatively easy to remove a tumor, but filling the "hole" left by the tumors erosion is an absolute technical challenge.
The base of the skull is like the ceiling of a floor, isolating and protecting the intracranial tissues within a specific area from external invasions. If the base of the skull "leaks", cerebrospinal fluid will flow down through the nasal cavity, and bacteria in the air will also invade, with unimaginable consequences.
The experts first carefully divided the bone removed from the surgical "window" into two pieces, one for restoring the surgical "window" and the other for plugging the "hole" at the base of the skull.
Under a high-power microscope, experts separated the skin on the forehead into multiple layers and used the peeled skin layers to wrap the bone pieces like a sandwich to "plug" the "hole" at the base of the skull.
Experts explain that the reason for such a "lengthy and complicated" process is to ensure that the transplanted bone does not die. These cortical layers are not completely disconnected from the original muscle, and they can continuously provide "nutrients" to the newly transplanted bone block, ensuring its normal survival.
Thanks to the experts rich experience, the operation went very smoothly. It took less than 40 minutes to remove the tumor and two hours to repair the "hole".
After the operation, the patients family said, "We had gone all over the place seeking medical help but to no avail. We never expected there to be such an outstanding expert right at our doorstep."
After the operation, Director Zou Wenhui (in the middle) visited the patient.
Expert Introduction
Zou Wenhui
Chief of Neurosurgery
Associate Chief Physician, Masters Degree
Member of the Neuro-oncology Committee of the Chinese Anti-Cancer Association
Medical expertise
Proficient in surgical treatment of glioma, meningioma, pituitary adenoma, intraspinal tumors and various tumors of the central nervous system.
Outpatient visit time
Monday, Wednesday, Friday
Pictures and Text | Liang Shan