Three surgeons perform a complex and delicate procedure to remove a vision-threatening tumor
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Sean Kerr was born with a mass near his temple that kept his left eyelid from opening and interfered with his ability to see. Over time, the mass grew and Sean's mother, Kathleen Kerr, was referred to Steven M. Archer, M.D., pediatric ophthalmologist at the U-M Kellogg Eye Center.
Dr. Archer was the first of several physicians from across the U-M Health System who provided Sean with the coordinated and highly specialized care he needed. While Dr. Archer knew that Sean had severe amblyopia, he realized that the tumor had to be treated first. Sean's next visit was with Alon Kahana, M.D., Ph.D., an oculoplastic surgeon specializing in tumors of blood vessels around the eye. One of Dr. Kahana's first steps was to order pictures of the mass using a dynamic contrastenhanced magnetic resonance angiogram (CEMRA), which is a new and advanced imaging system.
The CEMRA confirmed Dr. Kahana's suspicion that Sean had a rare form of arteriovenous malformation—a tumor of abnormal blood vessels—which involved both the tissues around the eye (orbit) and the front part of the brain. Given the type and location of the tumor, along with the potential surgical complications, Dr. Kahana called on two collegues for help: Joseph J. Gemmete, M.D., an interventional neuroradiologist, and pediatric neurosurgeon Cormac O. Maher, M.D.
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During the first part of the 10-hour surgery, Dr. Gemmete performed an extremely delicate procedure to embolize, or block, the abnormal vessels so they would not bleed during the rest of surgery. Next, Dr. Maher performed a craniotomy—a procedure where part of the skull is temporarily removed in order to access the brain and the orbit behind the eye. This allowed Dr. Kahana to remove the majority of the tumor without any severe bleeding episodes or complications. Because the tumor involved most of the upper eyelid, Dr. Kahana also reconstructed the lid to allow Sean to open the eye.
"Sean's surgery highlights the strengths of the entire U-M Health System with three different departments coming together and using the latest technologies to save this child's vision and protect his life," says Dr. Kahana.
Now 4, Sean is doing well. He can open his eye and is working with Dr. Archer to regain his vision. Every few months he sees Dr. Archer for patching—his strong eye is patched so his weak eye will develop—and Dr. Kahana to make sure the mass has not returned.
"This is the first time in Sean's life that his eye has looked normal," says Mrs. Kerr. "We're so thankful for Dr. Kahana. He is a wonderful doctor who even went so far as to give me his cell phone number so I could call him at any time with questions. It was a scary process but all the surgeons did a wonderful job. We're so lucky to have ended up at the University of Michigan."
For more information, see the Pediatric Ophthalmology Service or the Eye Plastic, Orbital and Facial Cosmetic Surgery Service at the Kellogg Eye Center.
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