Northwestern Medicine Surgeons Remove Extremely Rare Football-sized Cancerous Tumor from Patient’s Heart
Primary tumors of the heart impact less than .02% of the population
CHICAGO — When Michael DiLillo’s phone rang early on a Saturday morning, he was not prepared for the life-altering news awaiting him on the other end. The previous day he had undergone a series of cardiac tests and now his cardiologist was calling on the weekend.
“We were home babysitting our grandchildren when I saw he was calling. I remember him saying ‘I need to tell you something important. I hope you’re sitting down.’ That’s when I knew we were facing something serious,” recalled DiLillo, 69, a resident of St. Charles, Ill., in Chicago’s western suburbs.
For several months, DiLillo had noticed a slight tightness in his chest. He saw several physicians who told him he was going through the normal process of aging, but he wasn’t convinced.
“I was experiencing some chest issues – not severe or to the point where it limited my activity, but I knew something wasn’t quite right,” said DiLillo, who kept searching for answers. “When I got an appointment with Dr. Severino, he ordered tests and figured it out very quickly.”
When Michael J. Severino, MD, cardiologist at Northwestern Medicine Bluhm Cardiovascular Institute, called DiLillo on that Saturday morning, he informed him that the symptoms were the result of a large mass encroaching into his heart. He told his patient to head to the emergency department quickly to undergo further testing.
“When I saw the test results, I had to take a few minutes and decide how I was going to handle this because it was an earth-shattering result for the patient,” said Dr. Severino, who practices at Northwestern Medicine Central DuPage Hospital and Northwestern Medicine Delnor Hospital. “I’ve been in practice almost 30 years and I’ve never seen this type of tumor in this location.”
The tumor was growing into and causing damage to DiLillo’s heart. Treatment would require extensive surgery to not only remove the mass, but to also repair the damage to his heart. He consulted with surgeons at multiple hospitals, but none were willing to take on the surgery because of its complexity and risk.
“No one wanted to the do the surgery because they thought it was too risky. One surgeon said, ‘I can’t tell you with a clear conscience that you’ll survive surgery,’” said DiLillo. “I was scared beyond belief. I told [my wife] Marianne that we needed to put our financial house in order. I thought I was going to die.”
That was until he got to Northwestern Memorial Hospital. DiLillo first saw Samuel S. Kim, MD, thoracic surgeon at Canning Thoracic Institute, who brought his case to the hospital’s tumor board, a multidisciplinary team of experts who meet to discuss complex cancer patient cases and determine the best treatment plan.
“The patient was running on borrowed time and surgery was his only option for survival,” explained Dr. Kim. “At Northwestern Medicine, our surgeons are known for taking on the most difficult cases and we knew we had the right team in place to help Michael.”
After discussing DiLillo’s tumor, the tumor board agreed it would require the expertise of a cardiac surgeon given the damage to the heart, which is when Christopher K. Mehta, MD, cardiac surgeon at Bluhm Cardiovascular Institute, was brought into the case.
“I’ve seen a handful of these tumors, and this was by far the most aggressive appearing cancer, especially from what we could tell from the imaging and the echocardiogram,” said Dr. Mehta. “The sheer size of the tumor, which was the size of a football, was causing it to invade the structures of the heart, which made it particularly challenging to deal with.”
The sheer size of the tumor, which was the size of a football, was causing it to invade the structures of the heart, which made it particularly challenging to deal with.
Despite the tumor’s size and complexity of the surgery it would require, Dr. Mehta agreed to operate, but warned DiLillo and his family that it would not come without risk.
“The tumor was invading and compressing the pulmonary valve and the pulmonary artery, which move blood from the heart to the lungs,” said Dr. Mehta. “Once we removed the entire tumor, we would then be faced with having to reconstruct the heart in a way that he could live a normal life. It was a very involved surgical case.”
The surgical team operated for 12 hours removing the entire tumor then repairing the damage it caused to the structures of his heart, including rebuilding the pulmonary valve. For DiLillo’s family, the wait was agony.
“My kids were there with me, and we were all scared. It was a rollercoaster. We had ourselves prepared that he wasn’t going to make it,” said Marianne DiLillo, Michael’s wife of 41 years. “When Dr. Mehta came out and said everything went well, we couldn’t believe it. He let us all hug him and was so positive about the surgery but told us the recovery was still going to be a long journey.”
For Dr. Mehta and team, the relief was shared especially after seeing the tumor’s true size once it was removed. The tumor weighed more than 1.5 pounds, which is more than double the weight of the average human heart.
“When we opened Michael’s chest, you couldn’t see his heart because the tumor was so massive. We all breathed a sigh of relief when this surgery was complete,” said Dr. Mehta. “Michael still had a long road ahead of him, but we gave him an opportunity to keep fighting.”
Following surgery, DiLillo remained in the intensive care unit (ICU) for five weeks then transferred to an acute rehab facility for more than two months.
“From the time we had the surgery planned until several weeks after was a blur to me,” said DiLillo. “Having Marianne by my side and making big decisions was insurmountable because I could have never been able to function on my own.”
Primary tumors of the heart are extremely rare with malignant cardiac tumors being even more uncommon. Less than 10% of all primary heart tumors are cancerous affecting approximately 8,000 people worldwide. By comparison, breast cancer impacts more than 240,000 people each year in the United States alone. When cancers do occur in and around the heart, most often the cancer started elsewhere and spread to the heart.
“When the pathologists got back to us about the type of tumor, they were very surprised to find that it was a liposarcoma, which is a rare type of cancer that starts in soft tissues,” said Dr. Mehta. “While Michael previously had a liposarcoma in his leg more than ten years earlier, the pathologist felt this was a primary tumor meaning it had started in the chest and then invaded into the heart. These represent about one percent of cancers of the heart, so it’s a very rare diagnosis.”
While DiLillo’s recovery has been long and challenging, he continues to grow stronger every day and recently enjoyed celebrating his first Christmas since the surgery with Marianne, their three grown children and their spouses and five grandchildren with number six on the way in March.
“You get a whole new perspective in how important every day is – you don’t want to waste time, you don’t know how much time you have,” said DiLillo when reflecting on the surgery and his recovery. “I have a second lease on life. I feel blessed that we found the right people who could help us. Dr. Severino found it when others said I was fine. Dr. Mehta took it on when others said, ‘I can’t help you.’ Northwestern saved my life.”
I have a second lease on life. I feel blessed that we found the right people who could help us. Dr. Severino found it when others said I was fine. Dr. Mehta took it on when others said, ‘I can’t help you.’ Northwestern saved my life.
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