A TUMOUR HAD GROWN BEYOND THE COCCYX: THE PATIENT NEEDED IMMEDIATE ASSISTANCE

A 64-year-old man visited the doctors of the Radiation Injuries Department of the A. Tsyb MRRC – the branch of the National Medical Research Oncological Centre of the Ministry of Health of the Russian Federation . For him, coming to the Obninsk Centre became the most real hope, because oncologists at his place of residence said that this was the only clinic where he could get help.

“My story began when I felt a mass in the coccyx area. At first, I didn’t pay much attention to it, but its rapid growth and obvious discomfort made me go to a specialist. I was immediately diagnosed with squamous cell cancer of the coccygeal area. The doctors decided to perform remote radiation therapy and 4 courses of drug treatment. I felt good and was ready to return to normal life,’ says Egor.

Six months later, the patient developed a post-radiation ulcer, which significantly reduced his quality of life. Moreover, regular PET/CT scans revealed metabolic activity in the ulcer area, which made it difficult for doctors to make an accurate diagnosis regarding a possible local recurrence.

So, Egor ended up at the A. Tsyb MRRC, which houses the only specialized department in the country dealing with the treatment of radiation injuries. “Our patient needed urgent medical care. The resulting post-radiation ulcer was not only causing unbearable pain, but also posed a serious threat as a source of infection. The Department of Radiation Injuries has considerable experience in performing reconstructive and plastic surgeries of this profile. We developed an individualized treatment plan that was aimed at solving his specific problem,” explained Victor Pasov, surgeon of the Radiation Injuries Department.

“During surgical intervention, after excision of the ulcer and fibrotic changes in the soft tissues of the sacrum, we found foci of osteomyelitis of an infectious-inflammatory process affecting bone tissue, as well as a locally spread purulent process. After thorough wound treatment, we proceeded to the reconstructive-plastic stage. The elimination of the formed defect required the use of tissue flaps, which included mobilization of subcutaneous fatty tissue and the large gluteal muscle. Skin and muscle flaps of the large gluteal muscle on both sides were isolated. In fact, we can say that we performed a kind of “tightening” buttocks, which allowed to close a significant defect, “says Nikita Gorbachev, an oncologist of the Department of Radiation Damage in A. Tsyb MRRC.

The operation was successful, and the next day the patient was verticalized. In the conditions of our Center, histological examination confirmed the presence of tumor recurrence, so after the rehabilitation period the man was prescribed a course of chemotherapy.

At present, Egor feels much better, actively moving around, spending time with his children and grandchildren and, most importantly, living without pain.