At 26 years, she measures 7 feet 8 inches and weighs about 130 kilograms, with a shoe size of 15-16. Four months after making it to the Guinness World Records for being the tallest woman, the young woman (name withheld on doctors’ request) from South Dinajpur district in West Bengal underwent a surgery at the All India Institute of Medical Sciences (AIIMS) earlier this month, for removal of a “giant” brain tumour which was responsible for secretion of growth hormones up to 16-18 times above the normal level for the last 15 years.
“She developed a tumour known as pituitary adenoma when she was about 10 years old. By the time she was 15, she was already six feet tall. She became a spectacle in her village and was confined to her home by her parents who are illiterate and poor. She came to us about six weeks back. Scans showed this huge tumour, about four centimetres in size, at the base and middle of her skull,” said Dr Ashish Suri, professor of neurosurgery at AIIMS.
Her blood tests showed her growth hormone level was over 80 mIU/dl, against the normal level of 0-5 mIU/dl. “Her urine output was 6.5-7 litres per day, as compared to the normal output of 1-2 litres. We realised this was a classic diagnosis of gigantism, and the only option was to remove the tumour surgically,” said Dr Suri.
Doctors said if the tumour continued to develop after her growth was complete, she would grow in width. “There are many patients diagnosed with such tumours at a later age and they have a condition called Acromegaly where the hands, feet and face grow broader. In this case, she had it when she was very young, which compounded the symptoms… all her organs were enlarged,” said Dr Nikhil Tandon, professor of endocrinology at AIIMS.
He explained that since the pituitary gland is the “master of the endocrine orchestra”, the woman also developed several other problems. “All her organs are enlarged. Since the tumour was in the pituitary gland, hormone levels were abnormal… she has not reached puberty yet, her blood pressure is extremely high, she runs the risk of developing heart complications and has developed diabetes. Her calcium levels are really low… that coupled with the effect of being confined to bed has resulted in multiple fractures in her vertebrae, which made her spine curved,” said Dr Tandon.
The decision to operate came with many problems. “Our maximum bed size is six feet, both in the operation theatre and ICU, so positioning her appropriately for surgery was a big problem. Her head size was enlarged, which made access of the tumour with our instruments like endoscopes extremely difficult. Anesthetising her would be a problem with her head size, since we did not have endotracheal tubes of her head size, and she had difficulty lying down with the multiple fractures in her spine,” said Dr P K Bithal, head of neuro-anesthesiology at AIIMS.
But if the tumour was not removed soon, she had continued…