Pediatric Surgery Team
A team of pediatric specialists at work at UNM Hospital.
Credit: Rebecca Gustaf

A medical team at University of New Mexico hospital has removed a significant portion of a watermelon-sized tumor from an 11-year-old boy, who is recovering in an intensive care unit at the hospital.

Approximately one-third of a tumor was removed from José Ramirez Serrano’s neck area during the 11-hour surgery on Nov. 17, according to lead clinician and pediatric surgeon Cynthia Reyes, MD. “His vital signs are strong and he appears to be recovering well at this stage,” she said. “In addition to the strong love and spirit of José’s family, there are a lot of people here affectionately watching over him.”

Serrano came to UNMH nearly two years ago, after members of Rio Rancho First Baptist Church met him during missionary work in Juarez, Mexico. He was brought to New Mexico with support from Gov. Susana Martinez, who was instrumental in securing visas for the family to ensure the surgery could be performed at UNMH. The church has provided transportation, meals and lodging for the family.

After an initial evaluation at UNMH’s multi-disciplinary Vascular Lesions Clinic, Reyes and her team were concerned that the invasive but benign tumor was encroaching on Serrano’s wind pipe. The 97-pound boy was suffering periodic bleeding and infections within the mass, as well. Exhaustive evaluation and imaging led to attempts to treat the mass medically. Although growth was successfully arrested over the past two years, the team decided to attempt surgically removing the tumor.

The lesion was present on the boy’s lower neck at birth and was about the size of half a lemon, according to Reyes. As Serrano grew, so did the tumor – up the left side of his face, down the left side if his neck, over his left shoulder and across to the other shoulder, and in his chest and back. It’s composed of multiple cysts and spongy-soft tissue with a vast network of small, medium and large veins. Despite regular attempts at local clinics, he was denied medical care throughout his childhood.

“This was a complicated procedure requiring seamless integration from a diverse team of pediatric specialists using cutting-edge instrumentation,” said UNM Chancellor for Health Sciences Paul Roth, MD. “We’re proud of the extraordinarily talented group assembled by Dr. Reyes and their well-researched medical strategy developed to help this little boy.”

The pediatric medical team consisted of two pediatric surgeons, two cardiac surgeons, three otolaryngologists, two plastic surgeons, three anesthesiologists, a neurologist, a dermatologist, a hematologist/oncologist, the New Mexico Blood Bank and an ear, nose and throat visiting professor from the University of Arkansas, Gresham Richter, MD. Five pediatric surgeons, three pediatric anesthesiologists, a hematologist and a neurologist were in the operating room during the 11-hour procedure.

Because the mass was so vascular, the team determined about midpoint in the surgery that the best course would be to de-bulk the tumor where there was less vulnerability to nerve damage and infection, and where spontaneous bleeding and infection had been recurrent. A wedge measuring 30x10x10 centimeters was successfully removed.

“We were able to reduce the weight and bulk on José’s shoulder while excising tissue that had recurrent bleeding and infection,” explained Reyes. “José will have greater range of motion in his neck and shoulder, and his coagulation and clotting responses should improve.”

Reyes expects Serrano to heal in approximately six months while the team performs additional medical treatments to effectively shrink the tumor. “We want this charming, rambunctious, brave boy to be able to ride his bike, play soccer and generally do the things that little boys do,” Reyes says. “We believe he’s on his way to a more normal, active, healthy life.”