Epic effort to replace giant tumour with 3D implant


A patient with an “enormous” rare tumour wedged in his ribs has been saved by a large team of specialists at Sydney's North Shore Private Hospital after a marathon 23-hour procedure performed over two days.

The growth was so large that David Rashleigh, 54, required part of his spine to be removed in order to take it out, and a “unique” 3D-printed plastic implant to fill the gap it left.

Dr Michael Harden led a team of five consultant surgeons and two anaesthetists, aided by nursing and allied health support staff.

“The tumour itself was enormous, between 25 and 30 centimetres, and it seemed to be attached to his chest wall, and it’s that position that made it very difficult,” said Dr Harden, a cardiothoracic surgeon.

“It was in his back, nestled between three ribs and sitting very close to his aorta, so we needed spinal surgeon Dr Randolph Gray to help take off part of his spine and remove the tumour, right in the region where the spinal cord sits.” 

Dr Harden said multiple complications made planning the surgery particularly challenging.

“We realised the problem, after we remove a defect like that, is we can’t just leave a cavity the size of a rockmelon. To save his chest from caving in after surgery, we engineered a 3D-printed, customised chest cavity because we needed to have a unique way of securing the implant to the spine,” he said.

Dr Harden said he had “never done anything like it” – from the patient's rare condition (a solitary fibrous pleural tumour) to the length of time of the procedure and the size of the required surgical teams.

“We had to keep repositioning the patient on the table, from his side to his stomach and then back onto his side,” he said. 

“The implant itself was very unique and I think it’s amazing that we can do it here in Australia, using Australian technology. This was a very personalised surgery, nothing off the shelf.” 

The North Shore Private team engineered a 3D-printed, customised chest cavity

Mr Rashleigh's tumour was diagnosed after he went to his general practitioner due to stomach pain.

"I initially had an abdominal CT scan and they noticed some shading in the lung area. I then had a chest CT and a PET scan which revealed the true nature of the tumour,” he said. 

“I was extremely fortunate that this was picked up just in time. Despite being large, aggressive and invasive, it had produced minimal symptoms at the point of diagnosis.” 

North Shore Private Hospital CEO Richard Ryan praised the “great collaborative effort” from all medical, nursing and allied health staff to treat and support Mr Rashleigh.

“The whole Ramsay philosophy of people caring for people has really shone through, with all the surgeons, theatre teams, facilities and implant engineers working together to provide the best outcome for Mr Rashleigh,” Mr Ryan said.

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