MUMBAI: When 35-year-old tractor driver Pradip Naik walked into JJ Hospital on July 4, he was in a lot of pain—not only due to the growth that doctors in his native Buldhana found in his chest, but also because they told him that they couldn't help him.
"I thought I had a growth in my lungs that was untreatable," he said on Monday, free from the pain for the first time in four months.
Doctors in the state-run JJ's surgery department found that the "growth" in Naik's chest was five delicate cysts of a tapeworm called Echinococcus granulosus. These cysts—called hydatid cysts—could have burst any time, causing an emergency. On August 4, doctors removed them in a three-hour operation.
Tapeworm-related infections are quite common in India in comparison to the rest of the world. JJ doctors said the incidence of hydatid disease worldwide is 1 in 200 to 1 in a lakh.
"We get 10-odd cases of hydatid cysts every year, but most of them are attached to the patient's liver," said Dr Ajay Bhandarwar, professor from the general surgery department of JJ Hospital. "But in Naik's case, the cysts bypassed the first filter of liver and reached the lungs as well as the spleen."
This is a rare case because of the combination of cysts in the lungs and spleen, the doctors said. "This is the first time such a case has been handled with minimally invasive surgery in world medical literature."
The cyst attached to his spleen was the biggest, with a 10cm diameter. Two of the cysts not only touched the lungs, but also the outer covering of the heart. "Care has to be taken to ensure these cysts don't break while removing them laparoscopically," said Dr Amol Wagh, who, along with Dr Bhandarwar, performed the operation. "As the heart was beating, it was not easy to remove the cysts. It seemed like repairing something when its engine was on."
The doctors believe Naik got the cysts from his pet dog, which was possibly infected with tapeworms and shed tapeworm eggs through faeces. If ingested by humans, the eggs form an embryo that is protected in the form of a cyst.
Naik has undergone post-operative scans and has been put on a deworming course to prevent recurrence.