Thane doctors boost healthy liver before removing large tumour from 66-year-old woman

Doctors at KIMS Hospitals in Thane have removed a large tumour from the liver of a 66-year-old woman. The tumour had spread across about 75% of her liver. The case, which came to light in October 2026, was operable, but the surgery carried a major risk.

The doctors estimated that only about 25% healthy liver would remain once the tumour and the affected part were removed. So instead of operating immediately, a multidisciplinary team led by Dr Saniya Pandrowala, consultant GI and HPB oncosurgeon at KIMS Hospitals, Thane, first worked to increase the amount of healthy liver available for the surgery.

The woman also had asthma, high blood pressure and heart problems. Dr Jinesh Singhvi, consultant medical oncologist at KIMS Hospitals, Thane, began her treatment with immunotherapy and targeted therapy. Meanwhile, Dr Neeraj Shetty, vascular and interventional radiologist at KIMS Hospitals, Thane, performed a special procedure to increase the functioning part of the liver. In it, the blood flow going to the diseased part of the liver was diverted. The healthy part received more blood, which helped it grow gradually in size.

Over the next few months, the proportion of the liver that would function after surgery (the future liver remnant) rose from about 25% to nearly 45%. This allowed the doctors to carry out the operation to remove a large part of the liver.

Dr Pandrowala said, "The tumour was so large that the challenge was not only removing the cancer. It was also essential to make sure enough healthy liver remained so that the patient's body would keep working properly after the operation. So instead of rushing into surgery, we planned the treatment in several stages."

Speaking about the interventional radiology procedure, Dr Shetty said, "When a large liver tumour leaves only a small portion of healthy liver, removing the tumour immediately is not necessarily safe. Our role was to selectively divert blood flow towards that portion to increase the amount of healthy liver before surgery. Over the next few months, this raised the proportion of healthy liver from about 25% to nearly 45%. That made a more adequate functioning part of the liver available for the planned operation."

During this period, given the patient's age and existing conditions, her nutritional status, physical fitness and respiratory health were also monitored. Once the amount of healthy liver had increased sufficiently, she was considered fit for surgery. The team led by Dr Pandrowala successfully carried out the operation to remove a large part of the liver, in which the affected part was removed along with the tumour.

The surgery was successful and the patient showed good improvement. She was kept in hospital for about 10 days. During this time she briefly developed fluid accumulation in the abdomen, which was treated successfully. Her condition has also been reported as good in later routine check-ups.

According to the doctors, the case also points to a changing trend in liver disease. Liver cancer was earlier linked with hepatitis and alcohol-related liver disease. But metabolic problems such as obesity, diabetes, high blood pressure and fatty liver are now increasingly emerging as important risk factors.

Dr Pandrowala said, "Fatty liver is often detected by chance in scans done during routine check-ups. Symptoms need not show in the early stage. But in some people the condition can progress and cause serious damage to the liver, and in some cases it can also raise the risk of liver cancer. Keeping weight, diabetes and other metabolic problems under control and taking proper medical monitoring can help reduce the risk of the disease progressing."

The doctors say the case underlines how important it is, in patients who are unlikely to be left with enough functioning liver after a large tumour is removed, to treat in stages and to plan to increase the working part of the liver before surgery.