Cured of a Challenging Tumor: Bisant’s Story

Dr. Bisant Labib

It was early in 2020 when a bothersome pain and stiffness in Bisant Labib’s neck and back started to get much worse. At the time Dr. Labib, an optometrist in Philadelphia and an associate professor at the Pennsylvania College of Optometry, was working from home due to the pandemic, and the pains shooting down her shoulders and arms were interfering with her daily activities, from typing at her computer to drying her hair. Thinking it was a disc herniation, Dr. Labib had been trying to manage it with yoga. However, the pain kept getting worse.

Then in May 2021, Dr. Labib started getting frequent episodes of extreme facial pain. Wondering if the problem was a new flareup of a recent bout with shingles, she went to a neurologist at Penn Medicine in Philadelphia, who ordered a head MRI. The scan happened to catch the top of her spine, where it revealed part of a mass that was large but hard to identify. So Dr. Labib went for a follow-up MRI of the spine. 

Pre-op MRI shows large brightly colored tumor (arrows) in the very enlarged spinal cord.

“That's when they said the mass was likely a very, very large intramedullary tumor,” she says. Spanning from the C1-C6 vertebrae, the tumor was thought to be benign, but its location inside the spinal cord was blocking the cerebrospinal fluid, which cushions and nourishes the brain and spinal cord. The tumor may have been growing slowly for 10-20 years. “It was a complete shock to me. But all the headaches and back pain started to make sense. Being in my profession, I knew how rare this was, and I was scared by how large it was.”

Wanting several opinions, Dr. Labib had consultations with neurosurgeons at Penn Medicine, Johns Hopkins, and in New York City, and there was one name she kept hearing: “Everyone, without a doubt, recommended Dr. McCormick.”

Dr. Labib started reading about Paul C. McCormick, MD, Co-Surgeon-In-Chief of NYP Och Spine Hospital and Director of the Spine Hospital at Columbia University Irving Medical Center. She was impressed by his wide range of publications and experience.

“Most other surgeons I consulted had only done a handful of these types of tumors in their entire career,” she says. “If anyone was going to possess the judgment, skill, and experience to handle a tumor as rare as what I had, it would be Dr. McCormick.”

During their first virtual visit, Dr. Labib was pleased to discover how much she also liked Dr. McCormick personally: “He was very knowledgeable and reassuring, which is what you look for in a surgeon.”

For his part, Dr. McCormick echoed other surgeons’ recommendations that the tumor come out as soon as possible. “It was in a very dangerous location,” he remembers. “Having a tumor in the actual spinal cord presents a rare and challenging situation. Only very few doctors can successfully and safely remove it.”

But Dr. McCormick also wanted to make sure Dr. Labib fully understood the procedure and what to expect. For example, accessing the tumor would mean cutting through the spinal cord, causing damage that could impair motor and sensory functions—and require a long recovery process to regain them. Because of that risk, Dr. McCormick was clear that removing the entire tumor was only a secondary goal; the priority was to preserve as much function for Dr. Labib as possible, which only a highly experienced spinal neurosurgeon can do.

“Another surgeon may have aimed for total resection without considering if removing it all would cause more harm in the long run,” says Dr. Labib, who credited Dr. McCormick’s experience with informing his judgment. “He didn't promise me anything that he couldn't say for sure. I felt like he knew what he was working with.”

Surgery was scheduled for a month out on August 16, 2021.

A Life-Saving Procedure

Dr. Labib met Dr. McCormick in person the first time the morning of her procedure. “He was very confident and even-keeled; I knew I was in good hands.”

Because intramedullary tumors arise from within the center of the spinal cord they are the most difficult tumors to safely take out, says Dr. McCormick. The procedure requires making a precise incision into the spinal cord to expose the tumor then using microsurgical techniques under high magnification to open the spinal cord and identify the tumor. The tumor must then be separated from the surrounding spinal cord.

“The spinal cord is very delicate and only gentle surgical techniques can be applied in order not to injure it,” Dr. McCormick explains. “The location of Dr. Labib’s tumor was also a challenge because it was in an area of the spinal cord that not only controls sensation and movement in the arms and legs but also the ability to breathe.” An additional challenge was the tumor’s large size, extending from the top of the spinal cord at the first cervical level down to the fifth cervical level. But after many hours under the operating microscope, Dr. McCormick was able to remove the whole mass: “We took it out completely and cured her of the tumor.”

Although Dr. Labib’s entire body was numb upon waking up from surgery, she had motor function, which was a good early sign. After a brief scare of high fever, her temperature normalized and she was moved to a main patient floor. A few days after surgery she was using a walker.

Dr. Labib’s inpatient recovery progressed smoothly thanks, in part, to the expert hands she was in. “I had the best care ever,” she says of the attention she received at NewYork-Presbyterian Och Spine Hospital. “The nurses were so readily available, very knowledgeable, and very caring—it was a very skilled staff.”

From the hospital, Dr. Labib was moved to inpatient rehab and was then discharged early. Once home, she continued her recovery process, with some functions returning quickly, and others needing more time. By year’s end, Dr. Labib was running, driving, and back to work administratively (she had not yet regained enough fine motor function to see patients). The shooting pains that had first prompted her to seek treatment were gone.

“My activities of daily life are not as impacted as I had suspected, even this early into my recovery,” says Dr. Labib. “To this day, when I meet with Dr. McCormick for follow-ups, he encourages me to have a horizon view and allow myself time to heal.”

As Dr. Labib continues along her path to full recovery, she feels enormous gratitude for the Columbia team that saved her.

“I cannot be more thankful for Dr. McCormick,” she says. “I don't think anyone could have done as good a job as he did.”