As the family struggled to meet the cost, the hospital led an initiative with friends and well-wishers to raise ₹30–35 lakh for the newborn’s life-saving treatment

Bengaluru : In a landmark achievement for oncology in orthopedics, HCG Cancer Centre, Bangalore, gave a new lease of life to a 28-day-old baby girl battling Infantile Fibrosarcoma, one of the rarest soft-tissue cancers seen in newborns.

The baby was born at another hospital with a small swelling on her right forearm that grew alarmingly within days into a massive tumour measuring 11.3 cm × 9.8 cm, engulfing her tiny forearm and hand. She had already been evaluated at multiple hospitals, where amputation was suggested as the only option, leaving her parents devastated.

But at HCG Cancer Centre Bangalore, a multidisciplinary team of over 14–16 super-specialists, supported by engineers and advanced planning technologies, combined their expertise to deliver a life-saving and limb-preserving treatment worth around ₹30–35 lakhs. Knowing the family was struggling financially, the hospital reached out for help, and friends, well-wishers, and the HCG team stepped in, contributing funds and support.When the baby was brought to HCG, she was in a critical condition, with low haemoglobin, functional compromise of the limb, and a rapidly growing, fungating mass.

At HCG Cancer Centre, under the guidance of Dr Pramod S Chinder, Director and Head – Orthopaedic Oncology, along with Dr Sunil Kumar H R, HOD Anaesthetist, and the plastic and reconstructive surgery team conducted a detailed assessment. The tumour was found to surround major blood vessels and nerves, making the limb extremely fragile and the surgery exceptionally high-risk.

Genomic testing revealed an NTRK gene fusion, a rare genetic alteration that drives the rapid growth of cancer, with an incidence of just 0.3 per 100,000 population. Given the complexity and rarity of the case, the HCG team consulted and discussed the treatment strategy with internationally renowned orthopaedic oncology experts, Dr Marco Manfrini and Dr Laura Campanacci, distinguished International Faculty from the Rizzoli Orthopaedic Institute, Italy. Their expert inputs helped validate the limb-salvage strategy and staged surgical approach, reinforcing confidence in pursuing a function-preserving plan for the neonate.

Given the baby’s fragile physiology and the tumour’s extreme vascularity, the treatment was planned as a multi-stage approach over one week, ensuring maximum safety at every step.

The process began with a critical preparatory step led by Dr Indu Shekar, Interventional Radiologist, who performed super-selective embolisation by guiding micro-catheters through the newborn’s tiny vessels to block the tumour’s blood supply.

This step was crucial as it prevented catastrophic bleeding and made the subsequent surgery significantly safer.Simultaneously, Dr Sunil Kumar H R orchestrated an exceptionally precise neonatal anaesthesia protocol.

Managing a critically ill neonate during prolonged surgery required meticulous micro-dosing, thermoregulation, and continuous haemodynamic monitoring, considered among the most challenging aspects of paediatric surgical care.

This was followed by a 7–8-hour high-precision tumour resection under the leadership of Dr Pramod Chinder. Given the microscopic size of blood vessels and nerves in a newborn, the surgery required ultra-fine dissection supported by 3D-printed planning models developed by The Purple Spark Bioengineering, Digital Twin technology, and specialised micro-instruments to achieve complete tumour removal while preserving essential structures.

The surgical team also utilised Digital Twin technology to create a three-dimensional virtual reconstruction of the baby’s anatomy using MRI and CT imaging.

This enabled surgeons to visualise the tumour and surrounding structures in detail before surgery, allowing meticulous planning and minimising intraoperative surprises.

Two days later, the plastic and reconstructive surgery team performed one of the youngest microvascular free flap surgeries ever reported globally. A small flap from the thigh was transplanted to the right forearm, and microvascular anastomosis was performed to re-establish blood flow and preserve long-term hand function. Post-operative wound care and meticulous monitoring ensured gradual healing.Dr Pramod S Chinder, Director and Head – Orthopaedic Oncology, HCG Cancer Centre, said,”To encounter Infantile Fibrosarcoma, an aggressive tumour covering the right forearm and half the hand in a 28-day-old infant, is to face a battle for life itself.

This was a race against time and extreme tissue fragility, where only a multidisciplinary approach and molecular precision could prevail. The rapid genomic diagnosis, pinpointing the critical NTRK gene fusion, was our turning point.

It empowered us to execute a meticulous, multi-staged surgical plan not just to save her life, but to preserve the future function of her hand. Dr Sunil’s expertise was instrumental in navigating the physiological fragility of the 28-day-old patient, ensuring hemodynamic stability and continuous, nuanced support that made the high-risk surgery possible.

The treatment was delivered through a carefully planned, multi-stage approach over nearly a week, with each stage designed to maximise safety while preserving both life and limb.

This victory is a profound testament to medical innovation, turning despair into a miracle of hope.”He further added, “Parents should not panic when faced with a rare cancer diagnosis. It is important to seek treatment at specialised centres that regularly manage such complex sarcomas rather than relying on fragmented opinions.

The right expertise can make the difference between amputation and limb preservation. Financial concerns should never delay treatment, as help is available when families and healthcare teams come together.”The baby’s treatment cost approximately ₹30–35 lakhs.

Nearly 300–400 individuals came together to support the family through contributions from The Yellow Ribbon (Orthopaedic Oncology Unit), HCG Foundation, AaroCare Foundation, Milap crowdfunding, doctors, hospital staff, friends, well-wishers and even around ten students who donated nearly ₹20,000 from their personal savings.

This collective effort was further strengthened by the generous support of Dr. B. S. Ajaikumar and family, HCG Foundation and HCG Cancer Hospital, Ms. Manisha Kumar, Dr. Pramod S. Chinder and his family through the AaroCare Foundation, Mrs. Ratnamma Shekarappa, Mrs. Geeta Swami, and Dr. Krithika Murugan and family, whose contributions ensured that financial constraints never delayed the newborn’s life-saving treatment.

Following surgery, the baby was started on child-safe Entrectinib, an NTRK-targeted inhibitor, to prevent recurrence. Now, nearly one year and six months after surgery, the child has full limb preservation, is gaining strength, shows no recurrence, and is growing like any healthy infant.

For the parents, watching her move her fingers again was “a miracle beyond words.”Ms. Manisha Kumar, COO, Karnataka, HCG Cancer Hospitals, said, “This remarkable case reflects the power of multidisciplinary expertise, advanced technology, and compassionate care.

At HCG, we are committed to ensuring that every patient has access to world-class cancer treatment, regardless of age or financial circumstances. While our clinical teams successfully preserved both the life and limb of this newborn, the unwavering support from our foundations, staff, well-wishers, and the community ensured that financial challenges never stood in the way of treatment.

This journey is a testament to what can be achieved through innovation, collaboration, and compassion.”The baby’s parents said, “When we were told that our baby’s arm might have to be amputated, we felt completely helpless.

The doctors at HCG gave us hope when we had almost lost it. Today, seeing her move her fingers and grow like any other child is nothing short of a miracle. We will always be grateful to the doctors and everyone who supported our daughter’s treatment.

“About HCG Cancer Centre, BengaluruHCG Cancer Centre, located in Bangalore, has been revolutionising cancer care since its inception and has helped patients achieve longer and better lives. Since its inception in Bangalore, it has grown to become the largest network of Cancer Care Hospitals in India. HCG Cancer Centre Bangalore is equipped with the world’s latest technology for the diagnosis and treatment of all cancers—from high-end nuclear medicine and PET-CT to Genomics for diagnosis, CyberKnife, Adaptive Radiotherapy, Robotic Onco-surgery, Gene Therapy, CAR-T Cell Therapy, coupled with Precision Oncology treatment protocols with a multidisciplinary approach for patient care by experts.