Loyola surgeons remove extremely rare tumor from 9-year-old girl

By Jim Ritter and Anne Dillon

(Medical Xpress) -- Loyola University Medical Center surgeons have successfully removed an extremely rare pancreatic tumor from a patient who was only 9 years old.

Such occur in about 1 in every10 million children, said Dr. Heather Paddock. "It's the first case I have seen in my career, and almost certainly will be my last," Paddock said. She plans to write a report about the case in a .

Paddock and Dr. Margo Shoup removed the 1 ½-inch from Alexis Guzman of Franklin Park, Il. Alexis has made a quick recovery from the 4 ½-hour surgery. She is going into fifth grade at Washington Elementary School in Schiller Park, where she has made the honor roll.

The tumor, which turned out to be benign, was located on the head of the pancreas. Paddock and Shoup performed an extensive surgery known as the Whipple procedure. They removed the head of the pancreas, the far end of the bile duct, the first part of the intestine, part of the stomach and the entire gallbladder. (The procedure is named after Dr. Allen Whipple, who developed the surgery.)

Shoup has performed more than 200 Whipple procedures. Previously, her youngest Whipple patient was 22 years old. Shoup said that doing a Whipple on a child is challenging because the organs and structures are smaller. But children also heal quickly. After her extensive surgery, Alexis spent just six days in the hospital, and was back in school in three weeks. Alexis recalled that after the surgery, "I was tired, but it didn't hurt."

Doctors don't know what caused Alexis' tumor. The symptoms included severe abdominal pain and loss of appetite. Her primary care physician admitted her to a community hospital, which performed a CT scan that detected the tumor. Alexis then was transferred to Loyola.

Alexis' father, Guillermo Guzman, said he was frightened when he learned about his daughter's diagnosis. "I was worried and concerned," he said. "But with good prayers, I knew she would be OK."

Paddock is specially trained in providing surgical care to pediatric patients. Her medical interests include congenital abnormalities, gastroesophageal reflux, congenital diaphragmatic hernia, pediatric trauma and burns, and minimally invasive surgery. She is an instructor in the departments of Pediatrics and Surgery at Loyola University Chicago Stritch School of Medicine.

Shoup is chief of the Division of Surgical Oncology of Loyola University Medical center and a Fellow of the American College of Surgeons. In addition to the Whipple surgery, her medical interests include bile duct , colon cancer, esophagus cancer, esophagus surgery, gastrointestinal surgery, GIST, liver cancer, pancreas cancer, pancreas disorders, pancreas , soft-tissue sarcoma and stomach cancer.

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