After years of being robbed of a normal childhood, being unable to play football and hang out with friends, Mubarak Almenhali can now go back to enjoying all his favorite activities again.
Doctors at Cleveland Clinic Abu Dhabi, part of Mubadala’s healthcare network, recently treated the 15-year-old for paraganglioma, a rare type of tumor that arises from the peripheral nervous system that controls body functions including blood pressure, heart rate and intestinal movements.
Approximately two out of every million people suffer from the tumor each year, with a range of symptoms including high blood pressure, excessive sweating, emotional outbursts, headaches and stomach aches. The slow-growing tumor most often affects people between the ages of 30 and 50 and can be non-hereditary.
“Mubarak had already been to several hospitals in the UAE and India, but because of the complexity of the tumor that was next to the aorta, the main artery that carries blood to the rest of the body, they were unable to find the right treatment that would alleviate his symptoms and save his life,” says Dr. Yasir Akmal, a Consultant Surgical Oncologist in the Digestive Disease Institute at Cleveland Clinic Abu Dhabi, who was part of the multidisciplinary team that cared for the teenager.
“The tumor arises from the nerve cells around the body or the adrenal glands and tends to secrete hormones like adrenaline, which causes the fight or flight response, anger, high blood pressure and stress. Since these are uncontrolled bursts of adrenaline, it can lead to a stroke and heart attacks if untreated. Such an extensive tumor is very rare even in adults and this was one of the most complex resections that we have done for this type of tumor.”
The complex surgery required an integrated approach from the Heart & Vascular Institute, Digestive Disease Institute, Anesthesia team, Critical Care team and nursing staff at Cleveland Clinic Abu Dhabi.
“This was an eight-centimeter tumor and in a deep location, behind the stomach and close to the pancreas. It also had a lot of aggressive features, which means it was not completely benign,” says Dr. Yasir.
The tumor had blocked off the main blood vessels coming from the aorta, which supply the liver and small intestine. At the same time, the patient’s body compensated by forming large collateral blood vessels and different routes to supply blood to these organs. If this had not happened, his liver and intestine would have failed.
The surgical team had to be very careful during the resection to preserve these new channels and even had to reconstruct one that was supplying blood to his liver during the surgery. After the six-hour surgery, his progress was monitored in the intensive care unit to make sure the additional blood channels were functional.
“The connection that we had created for his liver was working well but he had lost blood flow to the gall bladder. So, we had to remove that and a small part of his pancreas. He was given antibiotics and supportive care to assist his recovery,” concludes Dr. Yasir.
Having completed his radiation to reduce the risk of recurrence in the same area, Mubarak can now look forward to returning to school. “I was told by so many hospitals that my surgery was not possible. But at Cleveland Clinic Abu Dhabi, they took care of me and took my pain away. I am excited to go to school and play with my friends and hang out after classes. I feel like my health is improving every day. My friends are waiting to see me. I share my progress with them on WhatsApp and hope to join them soon.”
His father, Ahmed Almenhali, adds: “We can’t thank the Cleveland Clinic Abu Dhabi doctors and nurses enough. I want to take a picture with all of them and tell the world that these great people helped my son live pain-free.”