Mum 'living again' after surgeons remove inoperable football-sized tumour

A businesswoman has been given a second chance at life after surgeons removed a 25cm tumour from her chest in a rare operation at Guy’s and St Thomas’.

Giovanna Distefano, 37, had no idea that the mass – as big as a football – had been growing between her lungs until unrelated stiffness in her neck prompted her to get a scan.

Doctors found she had a large, rare stage 4 thymoma - a relatively slow-growing tumour which had invaded major vascular structures in her chest.

Around 20 people per million globally have this type of cancer of the thymus gland, with it being more prevalent in people who are in their 40s and 50s. Thymomas bigger than 9cm are rare, making Giovanna’s tumour one of the biggest to be recorded.

Because of the size and complexity of the tumour’s location, Giovanna, who is a single parent to a three-year-old daughter, had been previously told it was inoperable and was given just months to live.

Now, a year since she had her first scan in early 2021, surgeons have removed the thymoma and her left lung and Giovanna has already travelled back to see family in her native Italy.

Giovanna lives in Hackney, east London, and runs hair and beauty salons in her home borough and in neighbouring Islington.

She said: “I feel like I am living again. I feel good. I’m walking two or three miles a day now, a bit like a 90-year-old woman, but I’m doing it. The surgery was a success. I can’t wait to go back to pilates classes and to start running again – having one lung isn’t going to stop me!”

Prior to her diagnosis, Giovanna had been busy running her businesses and caring for her daughter alongside keeping herself fit, and had no symptoms until she felt some stiffness in her neck and arms.

After several scans, Giovanna was told she had a large thymoma which was growing between her lungs, and which was inoperable. This prompted Giovanna to contact Andrea Bille, consultant thoracic surgeon at Guy’s and St Thomas’ NHS Foundation Trust.

With colleagues including Gianluca Lucchese, consultant cardiac surgeon at Guy’s and St Thomas’, Mr Bille has established an expert team which has now successfully operated on nearly a dozen patients like Giovanna who were previously told there was no treatment for their condition.

Mr Bille said: “While this was a slow-growing tumour, it had become huge. Because Giovanna is young and fit, her body had likely compensated for the thymoma and so didn’t notice it for a long time.

“A thymoma this big is rare – there have been only a handful of others that we know of in the world, and none in the UK.”

Giovanna initially had chemotherapy, then contracted COVID-19 and was hospitalised with related pneumonitis before she was ready for surgery in October 2021.

Giovanna’s operation is the only one of its kind which has been performed in the UK and is among just a handful in the world that are known to have taken place.

The surgery was particularly challenging due to the size of the tumour and its location in the mediastinum, which is the area of the chest that separates the lungs and includes the heart, aorta, oesophagus, thymus gland in the back of the neck, and windpipe.

During the complex nine-hour operation at St Thomas’ Hospital, Mr Bille cut open Giovanna’s chest in a T-shape to carefully remove the advanced thymoma and one of her lungs, while Mr Lucchese removed the mass from the cardiovascular structures and reconstructed two key veins running through her chest without the need of a cardiopulmonary by-pass machine.

Mr Lucchese said: “This advanced technique reduces the risk of complications but it is more challenging. It’s important to limit the invasiveness of such a complex operation to give the patient the best chance at a good recovery, which is why Andrea Bille and I worked so closely together in this case.”

The specialist surgical team at Guy’s and St Thomas’ is a collaboration with cardiology, oncology, radiology, anaesthetics and others.

Mr Bille said: “We set up a team to handle very complex procedures such as Giovanna’s – where patients have otherwise been told they aren’t operable. It offers a tailored service to these patients, and so far we have successfully treated 11 people.

“Giovanna is one of those and I’m delighted to see her getting her quality of life back to normal.”

Giovanna is being regularly monitored by specialists, but currently doesn’t need any further treatment for her tumour.

She said: “Through everything, Mr Bille was so professional and honest with me. He told me the reality, which I really appreciated. I just wanted the operation – I knew there were risks in having this surgery but I had all my trust in Mr Bille and his team. All the staff have been absolutely amazing and I got my strength from the people looking after me.”

“I have a strong mind-set, and I’m always well prepared so I used that to cope throughout this journey. And I put all my trust in my doctors. I am so glad I gave my body a second chance.”