Doctors at the Asian Institute of Nephrology and Urology (AINU) in Banjara Hills, Hyderabad, have successfully removed a rare, giant dumbbell-shaped testis tumor from a young man. This complex surgery was particularly challenging as the patient is a kidney transplant recipient on high-dose immunosuppressive medication.

The 39-year-old patient from Kadapa underwent kidney transplant surgery a year ago for end-stage kidney failure and has been on powerful steroids and immunosuppressants ever since. Recently, he noticed swelling in his left testis, which he initially dismissed as a simple hydrocele. However, the swelling rapidly grew, prompting further evaluation at AINU. The doctors discovered a large tumor extending from the left testis into the abdomen, surpassing the belly button. Lab tests revealed abnormally high levels of Beta HCG, a testis tumor marker, elevated to more than 20 times the normal value. Fortunately, a PET scan showed no signs of tumor spread to other parts of the body.

Given the patient’s condition as a kidney transplant recipient on immunosuppressive drugs, conventional treatments like chemotherapy and radiotherapy were not viable options. Surgery became the only feasible solution. After thorough preparation for surgery and anesthesia, the patient underwent a complex procedure under general anesthesia.

Dr. Rajesh Kumar Reddy Adapala, a consultant uro-oncologist, led the challenging surgery with surgical support from Dr. Dinesh. The anesthesia team, led by Dr. Nithyananda and Dr. Shifa, provided exceptional support, ensuring a smooth operation. Dr. Srikanth provided critical peri-operative Nephrology care, which was crucial for the patient’s recovery.

The surgical approach involved making an incision higher than usual, from the left groin extending into the abdomen, to avoid violating the tumor environment and reducing the risk of spreading to lymph nodes. The tumor was meticulously dissected without damaging surrounding organs such as the urinary bladder and major blood vessels and successfully removed. Measuring approximately 40cm, the dumbbell-shaped tumor was extracted with minimal blood loss and an uneventful surgery.

The patient was shifted out of the ICU on the first postoperative day and discharged on the third day. “Testis tumors are common among young men, but it is rare to see such a giant mass growing into the abdomen,” noted Dr. Adapala. The patient had a previous successful kidney transplant at AINU, and now he has undergone another complex yet successful surgery. Dr. Mallikarjuna C, Managing Director, and Dr. PC Reddy, Executive Director, expressed their pride in the team’s exceptional achievement.