AIIMS Kalyani Surgeons Excise Record 2.9 Kg Malignant Brain Tumour from 26-Year-Old

Surgeons at AIIMS Kalyani have excised a 2.9-kilogram malignant brain tumour from a 26-year-old man—an aggressive mass documented by the institute as the world's largest operated brain tumour of its kind. Sonai Mondal, a resident of Katihar in Bihar, had watched the growth erupt across his scalp over seven agonizing months. Multiple tertiary care centres across the country had turned him away as untreatable. AIIMS Kalyani admitted Mondal on September 15, confronting a cranial swelling measuring 45 by 42 by 32 centimetres with an outer circumference of 66 centimetres.

Leading neurosurgeons confirmed the diagnosis as a Malignant Peripheral Nerve Sheath Tumour (MPNST), an exceptionally aggressive cancer. Magnetic resonance imaging pinpointed a tumour mass measuring 20 by 18 by 17 centimetres that had eroded through the skull into the brain’s left parieto-occipital region. The growth had also invaded vital venous channels—including the superior sagittal sinus, transverse sinus, and the torcula. Dissecting the malignancy without triggering instantaneous, fatal haemorrhage demanded extreme operative precision.

Torrential Bleeding in Operating Theatre FourThe primary surgery took place on September 22. It lasted five hours and 45 minutes. As the neurosurgical team separated the external mass, dilated venous channels ruptured, unleashing torrential bleeding that drained approximately 9.5 litres of blood. The operating team immediately called a 45-minute surgical pause to stabilize the patient. Anaesthesiology and transfusion medicine specialists counteracted the haemorrhage through a massive emergency infusion, supplying 18 units of packed red blood cells, 12 units of fresh frozen plasma, and 11 units of platelets before the neurosurgeons re-entered the skull to excise the intracranial root.

Reconstruction and Path to RecoveryMondal survived the ordeal. Doctors extubated him 48 hours later, finding him alert, conscious, and free of new neurological deficits. Yet a secondary complication soon surfaced. Leaking cerebrospinal fluid formed a massive pseudomeningocele beneath his scalp, forcing a second operation in October. Surgeons harvested a fat graft and fascia lata from Mondal’s right thigh to patch the torn dural membrane, securing a titanium mesh across his cranium to reconstruct the skeletal perimeter.

Financed entirely under the central government’s Ayushman Bharat scheme, the multi-stage intervention was led by neurosurgeons Dr Saswat Kumar Dandpat, Dr Sourav Chowdhury, and Dr Kaustav Saha, under the leadership of Executive Director Prof (Dr) Arvind Sinha. "This is the world's biggest brain tumour," said Dr Dandpat, head of the neurosurgery department at AIIMS Kalyani. Mondal is now mobile, walking independently, and fit for hospital discharge, with the oncology team preparing his upcoming course of adjuvant chemotherapy and radiation.