First-of-Its-Kind Surgery Uses Eye Socket to Remove Spinal Cancer

Key TakeawaysA woman’s spinal tumor was removed through her eye socket in a first-of-its-kind surgeryDoctors threaded an endoscope down through her eye socket to drill into the vertebrae and remove the tumorShe also underwent two other surgeries to remove a tumor pressing on her brain stem.TUESDAY, May 13, 2025 (HealthDay News) — A first-of-its-kind surgery has gone through a young woman's eye socket to remove a cancerous tumor wrapped around her spine.Surgeons threaded a thin lighted tube called an endoscope down through the 19-year-old woman’s eye socket to remove a rare, slow-growing bone tumor known as a chordoma, doctors said after the successful procedure.“The tumor was wrapped around the patient’s spine and spinal cord and had invaded the vertebrae in her neck, just below the base of the skull,” Dr. Mohamed Labib, an assistant professor of neurosurgery at University of Maryland Medical Center, said in a news release.“By going through the bottom of the eye socket, we were able to remove a tumor that otherwise would have been very difficult and very risky to address,” he said.Trying to reach the tumor from the back would have risked damaging the spinal cord, Labib said.“We also avoided disturbing or damaging key structures such as the eustachian tube, major blood vessels such as the jugular vein and internal carotid artery, and nerves that control swallowing and speech,” Labib said.“We created a huge surgical corridor that enabled us to get in front of the spinal cord,” he added. “It was a straight shot.”The patient, Karla Flores, had started experiencing double vision at age 18, and spent months searching for the cause.“For a while, I didn’t know what was happening to my health,” Flores, 20, of Rosedale, Md., said in a news release. “It felt like no one understood or even believed that there was a physical reason for my symptoms.”Flores finally saw an ophthalmologist who agreed something was wrong and referred Flores to Labib, who diagnosed her chordoma. Only about 300 chordomas are diagnosed in the U.S. each year, doctors said.“They listened and took me seriously,” Flores said. “Learning about the spinal and brain tumors was terrifying, but I am so grateful that the doctors were able to remove them. I’m slowly recovering and with any problem I have, they help me.”Along with the spinal tumor, Flores also had a very large chordoma wrapped around her brain stem.In all, Flores had three separate surgeries, with two focused on taking out her brain stem tumor. Surgeons removed part of the brain stem tumor by opening her skull, and then took out the rest using an endoscope slipped through her nose.Endoscopes are thin and flexible, with a camera mounted at the end. Doctors run surgical tools through the tube to remove cancerous tissue.To take out the spinal tumor, Labib worked with Dr. Kalpesh Vakharia, chief of facial plastic and reconstructive surgery at the University of Maryland Medical Center.Vakharia carefully cut through the conjunctiva, the transparent membrane protecting the eye, inside the lower eyelid without disturbing the eye. He then removed the bottom of the eye socket and a portion of cheek bone to make a large enough pathway for Labib’s team to insert their endoscope and reach the spine.From there, Labib drilled through bone in the vertebrae to access the tumor and remove it.Surgeons have previously used routes through the eye socket to access tumors in the brain and sinuses, but this is the first time it’s been used to remove a spinal tumor, doctors said. Labib pioneered the new approach practicing on cadavers in neurosurgery labs at the University of Maryland.After the removal, Vakharia rebuilt the bottom of Flores’ eye socket using a titanium plate, and reconstructed the cheek with bone from her hip.“We wanted to develop a surgical plan where there would be no external scars and it would be impossible to tell that the patient even had surgery,” Vakharia said in a news release.Following her three surgeries, Flores received proton radiation therapy to destroy any remaining cancer cells. A neurosurgeon also fused the vertebrae at the top of her spine to stabilize it.“Karla is doing very well,” Labib said. “I am happy that through a very coordinated multidisciplinary team effort she had such a successful outcome.”However, Labib noted that Flores has some continuing trouble moving her left eye, due to nerve damage from the tumor that pressed upon her brain stem.“I keep reminding myself to take one day at a time and know that each step is an accomplishment,” she said. “I’m also glad I stood my ground and kept looking for help until I found it. Things could have gone horribly wrong if I didn’t believe in myself.”More informationThe National Cancer Institute has more about chordomas.SOURCE: University of Maryland, news release, May 5, 2025.What This Means For YouPeople with cancerous spinal tumors might do best to have them removed through their eye socket, based on this new procedure..Sign up for our weekly HealthDay newsletter