Doctors at Fortis Hospital, Vasant Kunj recently treated a seven year old boy from Yemen for what they describe as one of the rarest and most complicated cases- a brain tumor accompanied with a rare skin syndrome.

At the age of seven, a Yemeni boy weighed barely 16 kg and suffered from a rare skin syndrome after an "unsuccessful treatment" for brain tumour back in his country. His family then travelled to India, seeking treatment for the child at a leading private hospital about two years ago, where doctors described it as "one of the rarest and complicated cases".

On June 8- World Brain Tumor Day, doctors at the hospital shared the "curious case" of the Yemeni boy, who got a new lease of life post a surgery, but his case is still being monitored online, after he went back to Yemen. His case has given a few insights for treatment of brain tumour patients, especially in children, they said.

Brain tumour is a life-threatening medical condition which is caused by abnormal growth of brain cells. Not all tumours are cancerous. There are two main types of brain tumours benign (non-cancerous) and malignant (cancerous). "He was severely emaciated weighing only 16 kg at the age of seven (in 2016) apart from being extremely spastic with flexed arms and legs and had extensive lesions all over his skin with multiple episodes of seizures," said Anurag Gupta, consultant neurosurgeon at the Fortis Hospital, Vasant Kunj.

"What worsened the case was that the boy was suffering from a tumour in the cerebellum with hydrocephalus for which he had undergone VP shunt. However, post his earlier surgery in Yemen, he had developed a critical reaction to medication leading to infection and ventriculitis (inflammation of ventricles in the brain)," he said.

Hydrocephalus is a condition in which there is an accumulation of cerebrospinal fluid (CSF) within the brain. Ventriculoperitoneal (VP) shunting is a surgery to treat excess CSF in the cavities (ventricles) of the brain (hydrocephalus). "This was one of the rarest and complicated cases I had come across in my career," Gupta said.

The boy was started on Eptoin medicine as a result he had developed Stevens-Johnson syndrome, a rare syndrome characterised by serious disorder of the skin and mucous membranes, the hospital said. The boy was initially treated for his infection and kept in the intensive care unit (ICU) for nearly a month. Once he recovered from the infection, he underwent the surgery for the tumour and it came back as a "benign pilocytic astrocytoma" -- a brain tumor that occurs more often in children and young adults, doctors said.

"He is now recovering in Yemen and the doctors monitor his condition online," a spokesperson of the hopsital said. The exact cause of brain tumour is still unknown but there are some risk factors which may lead to brain tumour such as -- age, past medical history, family history, and radiation, said Mukesh Pandey, senior consultant, neuro and spine surgery department, at the Fortis Hospital, Shalimar Bagh.

"If someone ever had brain tumour, then chances of getting it back are more as some tumours are recurring in nature. If anyone's family members is having brain tumour or ever had brain tumour then chances of you developing brain tumour are high," he said.
Some of the symptoms of brain tumour include persistent headache, seizures, progressive weakness or one-sided paralysis, vision or speech problems and memory problems or behavioural changes, Pandey said. "Every year over 2,50,000 people are detected with primary brain tumour around the globe, accounting for over 2 per cent of all malignancies occurrence," according to Arunima Patel, a city-based doctor.