It was the kind of call patients about to undergo major surgery dream about: “We may have a better solution for you, a procedure that may better fit your lifestyle and age.” Those words were welcome news to Zoe Fantle, 40, of West Allis.
“I was completely taken aback,” she said. “There was complete relief and gratitude.”
Rare Desmoid Tumor
Zoe was scheduled to have a desmoid tumor removed from her abdomen in February 2014 by David King, MD, a Froedtert & MCW orthopaedic surgeon who specializes in bone and soft tissue tumors.
A desmoid tumor is a fibrous growth that develops in the connective tissue of the body or in scar tissue from previous surgeries. Although extremely rare, desmoid tumors can occur more frequently in individuals like Zoe, who has familial adenomatous polyposis, a genetic condition related to colorectal cancer. Zoe had undergone a colon resection years before. Desmoids are considered noncancerous because they do not metastasize, but they can grow aggressively and endanger surrounding tissues.
“The problem with desmoid tumors is that conventional treatment like surgery doesn’t always provide a long-term solution,” Dr. King said. “With surgery, there is probably a 40 to 60 percent recurrence rate of the tumor, even in the best of circumstances.”
Dr. King said it would have been a “very complicated” operation. “We would have removed the rectus abdominis muscle, which would have left a substantial defect in the abdominal wall.” A plastic surgeon would have rebuilt Zoe’s abdominal wall.
“I would have 100 percent gone through with the surgery,” Zoe said. “It sounded pretty scary and life-changing, but you do what you have to do to be healthy.” In the back of her mind were her husband and their two young children, and knowing that her mother and sister died of colon cancer.
But the phone call from Dr. King changed everything. Zoe’s treatment plan changed from an intensive surgery and reconstruction to CT-guided cryoablation, an outpatient procedure with a much faster recovery.
Dissolving Tumor With Cryoablation
Before Zoe’s surgery, the musculoskeletal team met as part of a tumor conference to carefully consider the most effective and efficient treatment.
“We came to the conclusion that cryoablation would be a better way to treat this tumor because it is less invasive than surgery,” said Sean Tutton, MD, a vascular and interventional radiologist. “Dr. King embraced the idea, saying, ‘This would be a better option. She’s a young mom, and surgery would really set her back.’”
Zoe hardly needed convincing.
“I was blown away when Dr. King called me,” she said. “I was so grateful that all the doctors from the different disciplines worked together. They looked at me as a whole, as a young mom, an active and fit person, and found a solution that fit everything — my lifestyle and my family.”
Dr. Tutton performed the cryoablation, with Zoe under light anesthesia, using probes about the size of a ballpoint pen cartridge, super-cooled by argon gas, to freeze her tumor.
“Using a combination of ultrasound and CT monitoring, we watch as the cryoablation probes enter the tumor and start the freezing process,” Dr. Tutton said. “We can actually see the freezing occur in real time on the CT scan. Temperatures plunge to -40 degrees centigrade. It’s so cold that cells basically burst; freezing injures the tumor’s cell wall, which causes the tumor to die. There are no incisions or sutures. The patient then recovers and goes home.”
Collaboration Leads to the Best Solutions
Follow-up scans showed the procedure succeeded. “I had the cryoablation in 2014, and I’m still doing well; it hasn’t come back,” Zoe said.
Phone calls like the one Zoe received are not necessarily routine. But the collaboration among specialists that leads to better solutions for patients is a routine part of care provided by Froedtert & MCW physicians.
“It’s really wonderful to work where medical experts come together to solve these tough problems,” Dr. Tutton said.
Zoe expressed deep appreciation for her doctors’ teamwork. “I feel so fortunate that they had the meeting before the surgery.”