MedWatch Today: Two Surgeons Team Up to Remove Rare Tumor from 11-Year Old Girl

When doctors found a very rare tumor in 11-year-old Jennavieve Garcia’s pancreas, it was a collaborative team of experts who helped her become her child again. dr. Amir Fathi of the Community Regional Medical Center worked with pediatric surgeon Dr. Shannon Castle of Valley Children’s Hospital and together they performed the Whipple procedure on Jennavieve.

The Whipple is a complicated surgery that is rarely performed on children. The patients of Dr. Fathi are not typically Jennavieve’s age.

He said, “Normally a surgeon like me who specializes in liver and pancreas is not called by the pediatric surgery colleagues, in terms of surgery on a child’s pancreas.”

But last winter, Dr. Fathi, the director of the Community Regional’s Hepato-Pancreato-Biliary Surgery Division, introduced to Jennavieve by Dr. castle. dr. Castle is a pediatric surgeon at Valley Children’s Hospital and discovered that Jennavieve had a rare tumor on her pancreas.

“She had a solid pseudo-papillary neoplasm, which is a fancy term for, this is a tumor that would continue to grow, but has the potential to become cancer, but it’s not cancer,” said Dr. castle.

Jennavieve said she had pain in her stomach since she was in kindergarten.

The young girl said, “I had a lot of stomachaches and I always called my mom and had to go to the office.”

Her mother Jessica Luna explains that for years there was no concrete diagnosis for her young daughter’s pain.

Jessica said, “When we went to the doctor it was like it was constipation or we had to change her diet. Maybe she has lactose intolerance… we literally changed her diet all the time.”

Last December, Jennavieve’s pain was unbearable and she was rushed to the emergency room at a nearby hospital and then transferred to Valley Children’s.

dr. Castle said, “She had issues with some pain and problems where she was blocking some of the outflow to her liver.”

dr. Castle suggested a procedure called a Whipple to remove the tumor from Jennavieve’s pancreas.

“This is a procedure I did in training, it’s not a procedure we do very often… and luckily I knew that Dr. Fathi she did. He is a surgeon trained as a surgical oncologist so he does this procedure several times a month which is more than I do… I contacted Dr. Fathi so we could do it together,” explained Dr. Castle out.

The Whipple is an extremely complex surgery that involves cutting and reattaching multiple organs in the gastrointestinal tract.

dr. Fathi elaborated on, “Whipple surgery, old-fashioned surgeons called it Cadillac of Surgery. It’s one of the most complex surgeries anyone can do, especially in the abdominal domain… The age of Jennavieve is something we’ve never seen this tumor happen before, I’d say there are less than a thousand cases in the medical literature have been reported.’

dr. Fathi knows the Whipple and Dr. Castle knows pediatrics. It was the perfect opportunity for the two to bring their talents together for Jennavieve.

“We are generally very cooperative. I think we’d love to work with other surgeons if you have complementary expertise, and absolutely if it’s best for the kids in the Valley,” said Dr. castle.

dr. Fathi added: “This is a great example of collaboration across the city. Someone like me who is familiar with the Whipple procedure who specializes and knows how to do it, work with someone who operates on children and knows how to handle a pediatric patient.

Jennavieve’s surgery was successful and the entire tumor was removed. Today she is healthy, prosperous and grateful for the work her two surgeons did well.

“This is a great example that surgeons, doctors can transcend bureaucracy, push the boundaries in the interest of their patients to provide the best care possible,” concluded Dr. Fathi.

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