Top Docs 2011

 

Nearly 300 of the very best physicians Denver has to offer.

 

Medical Miracle: Thrown A Curve

When a routine appointment turns into something altogether uncommon—and very scary.

“We’re people of faith,” Christopher Cole says. “So the first thing we did after hearing the results was to pray.” The impulse to solicit help from a higher power was understandable: A large mass had just been found in Cole’s daughter’s chest.

Anna Cole, 10, had gone to see the pediatrician about an increasingly noticeable curvature of her spine. Her parents thought it might be scoliosis. Instead, over the phone, the pediatrician told them the X-rays showed a growth the size of a cantaloupe living in Anna’s lung. It was pulling on her spine. “That’s not the kind of call any parent wants,” says Christopher, a cardiologist practicing in Colorado Springs. “But as a physician, I knew just enough to be very afraid.”

Christopher also knew finding highly qualified physicians for his daughter was the next crucial step. After a CT scan and a needle biopsy yielded little information about the type of mass they were dealing with, the Coles met with an oncologist and a surgeon in the Springs. There were a variety of possible diagnoses: It could’ve been a relatively rare congenital bronchogenic cyst, a malignant growth called a neuroblastoma, or a benign tumor called a ganglioneuroma. No matter what it was, it definitely had to be removed—which is how the Coles ended up in Dr. Steven Rothenberg’s offices at the Rocky Mountain Hospital for Children at Presbyterian/St. Luke’s Medical Center in Denver.

“The doctors in Colorado Springs were good people and good doctors I’m sure,” Christopher says, “but they weren’t offering the care we wanted for our daughter.” More specifically, they weren’t offering to do her surgery any other way besides an open thoracotomy, an invasive surgery that would leave the budding concert pianist with a 14-inch incision, an extended recovery time that would prevent her from playing a much-anticipated recital, and the possibility of developmental deformities as she continued to grow. Like everything else in life—and in medicine—the best course of action wasn’t exactly clear. So, they made a few more phone calls, and found Dr. Rothenberg.

“I’m probably one of the few surgeons in the country who would try to do this exact surgery thoracoscopically,” Dr. Rothenberg says with a sheepish shrug. “I just really thought I could do it.” Instead of opening Anna up from sternum around to her spine, Rothenberg would use four small openings and small surgical tools to do the procedure in a minimally invasive way. To the relief of Anna’s parents, he was correct. He could do it. But it took Rothenberg more than two-and-a-half hours to painstakingly extricate the tumor from her lung and spine. Then the surgeon had to dice the large tumor into small enough pieces to remove it through the four small incisions in Anna’s chest. “At that point we still didn’t know if it was cancerous or not,” Rothenberg says. “I had to use a plastic bag and make sure none of the tumor tissue touched the open incisions. Cancer cells can easily spread that way.”

It took 36 hours for the pathologist’s report to come back. When it did, the Coles learned that the tumor, which had collapsed more than one-third of their daughter’s lung, was not cancerous. It was an unusually large ganglioneuroma that had likely been growing for years, increasing in size slowly enough that Anna’s little body was able to compensate and avoid symptoms. By the time they received the call, Anna was already up and goofing around like a typical 10-year-old. In fact, just one week after Rothenberg made his first incision, Anna sat down in front of 50 people and tickled the ivories. The audience marveled at her—but not everyone knew just how miraculous her performance really was.