Soon after hepatobiliary and advanced gastrointestinal surgeon Alexander Itskovich, MD, arrived at CentraState to serve as medical director of the Statesir Cancer Center, he headed down to the Emergency Department (ED) to introduce himself to the team. While there, he asked the staff to give him a call should they encounter a tumor-related case. Six hours later, his phone rang.
Meanwhile, Marlboro resident Faye Ambrosio and her husband, Tom, had arrived at the ED that day at the recommendation of her primary care physician. Faye had been dealing with a fever for 10 days despite negative COVID-19 tests, and she had a nagging pain in her side. When a CT scan revealed a shockingly large abdominal mass, ED advanced practice nurse Diane Occhipinti, APN, BSN, MSN, placed the call to Dr. Itskovich.
“We were stunned when Diane showed us a ruler estimating the size of the tumor,” says Faye, 56, who works out and walks several miles nearly every day. “It was bigger than a cantaloupe. My head was spinning.”
They would soon learn that the tumor was even larger and more complex than they anticipated—and the chances of a tumor that size being cancerous were extremely high.
Planning the Next Steps
Within a few days, Faye and Tom met with Dr. Itskovich to discuss a surgical solution. The tumor was close to Faye’s colon, small intestine, uterus, bladder, and main blood vessels, including the aorta, so additional testing helped plan the approach. This included an MRI to assess soft tissue involvement, and a specialized CT scan to determine whether any blood vessels required closing and removal.
“It’s all about the planning—I tell my patients I do two hours of homework for every hour of surgery,” says Dr. Itskovich. “I build a mental model in my mind before any procedure. This meant considering every possible organ the tumor may have been touching and planning scenarios to deal with each one in the OR.”
“Dr. Itskovich was extremely thorough and prepared me for every unknown, including the possibility that I could lose a kidney or part of my bladder or colon,” says Faye. “The situation was overwhelming, but I knew I was in the right hands.”
Best-Case Scenario
Prior to surgery, urologist Matthew Pagano, MD placed stents (tiny tubes) to protect the tube that connects Faye’s kidney to her bladder, and he was on standby during the procedure in case the tumor involved these organs. With general surgeon Amit Kharod, MD, assisting during the surgery, Dr. Itskovich was able to meticulously remove the massive 26-cm (10-inch) tumor while preserving every organ except one ovary.
“No one could have imagined that I had a tumor the size of a baby inside me, pushing my organs around,” says Faye. “When I woke up, I was shocked and incredibly relieved to learn how well the surgery went.”
And even more surprising—subsequent pathology tests showed that the tumor was benign. “The outcome was really a miracle,” adds Faye, who is thrilled to be pairing her long walks with working out at the gym again. “I’m so grateful, and I’m now focused on enjoying life a little bit more.”
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