21 Aug 2012
When 42–year–old Dahisar resident Vinod Kumar Tiwari started suffering from bouts of palpitation and breathlessness a few months ago, he thought it was just his age and his physically demanding profession. Tiwari, who works in a plastic moulding factory, hit the panic button when his face and hands also started swelling up.
An X–ray showed that Tiwari had a knot in his heart and further examination indicated that he was suffering from a rare case of primary right heart synovial sarcoma or simply, cancer of the heart.
What makes Tiwari’s case exceptional is that only eight such cases have been reported worldwide, and doctors say this is possibly the first from India, making it a critical entry in the medical literature for cancer. The Annals of Thoracic Surgery, which contains details of all the cases, last recorded such a case in 2007, reported from Tunisia.
"Malignant tumours in the right side of the heart are extremely rare. When Tiwari was referred to us, we did not expect it to be synovial sarcoma and definitely not a malignant tumour. Detailed examination showed that the chambers of the right side of his heart were enlarged and a massive mobile mass was also visible. The oedema was indicative and helped us in diagnosing his condition," said Dr Shripal Doshi, senior cardiac surgeon at S R Mehta Cardiac Institute who operated on Tiwari a couple of weeks ago.
What makes Tiwari’s case even more interesting is the fact that synovial sarcoma occurs primarily in the extremities and is usually associated with joints such as the knee. "Primary cardiac synovial sarcomas are extremely rare and survival rate of patients is poor. If not treated, mean survival rate of the patient is about nine months to a little over 16 months. In the other cases reported, all but one patient died within a year," said Dr Tabassum Khan, who was assisting Doshi in the case.
Post a 10–hour operation, surgeons managed to remove only a part of the tumour. Removing the entire tumour would have severely damaged the heart. The remaining tumour will now be removed using chemotherapy, which Tiwari will receive at Tata Memorial Hospital.
Oblivious to the rarity of his brother’s condition, Dilip Kumar Tiwari is glad that he is alive and on the road to recovery. "The family was concerned about his heart condition. Now that he is better, we just pray that he is back home soon," he said.
Meanwhile, Doshi’s team has chronicled the details of the case and will soon publish it in national as well as international medical journals.