Foot removed from baby's brain in Colorado

Published: Friday, Dec. 19, 2008 12:38 a.m. MST
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COLORADO SPRINGS, Colo. (MTC) — Dr. Paul Grabb peered into the microscope at Sam Esquibel's 3-day-old brain, set on removing a tumor that threatened the infant's life.

What the pediatric neurosurgeon saw made him spring back in shock.

A foot!

As he surgically removed it, Grabb also found other partially formed appendages and what appeared to be ropes of an intestine tucked within the folds.

Sam survived the Oct. 3 brain surgery at Memorial Hospital for Children and is home with his parents and doing well. But his introduction to the world marks one of the strangest moments in medical history.

"It looked like the breach delivery of a baby," the pediatric neurosurgeon said last week, "coming out of the brain."

An exact diagnosis is unknown. The growth might have been a teratoma, a congenital brain tumor composed of foreign tissue such as muscle, hair or teeth. But such tumors typically are not as complex as a foot or hand.

It might have been a case of fetus in fetu, a developmental abnormality in which a fetal twin begins to form within another, but those have most often occurred in the torso and not the brain.

"You show those pictures (of Sam) to the most experienced pediatric neurosurgeons in the world, and they've never seen anything like it," Grabb said.

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Tiffnie and Manuel Esquibel had little reason to worry Oct. 1 when they went to the doctor. At 41 weeks, it appeared Tiffnie would need to be induced, but otherwise the pregnancy had gone smoothly.

Then an ultrasound revealed trouble in the baby's brain, and the delivery was planned immediately after the doctor's appointment.

After four hours of labor at Memorial Hospital North, Sam's health was failing. Tiffnie underwent an emergency C-section and Sam was taken to the neonatal intensive-care unit downtown.

By the next day, the couple encountered a doctor no parent wants to have to meet: the brain surgeon. Grabb asked them if they were religious, and they responded they were Catholic.

"He said, 'If I were you, I'd get your baby baptized before you go in,"' Tiffnie said.

An MRI had revealed a tumor, but its extent or possible malignancy were unknown. Babies cannot survive chemotherapy, and death would be almost certain if the tumor was cancerous. Even if benign, a tumor could wreak havoc on the baby's brain.

Grabb, southern Colorado's only pediatric brain surgeon, has seen a lot in the operating room. But in Sam's case, "I've never seen anything like it before."

About 37 percent of congenital brain tumors are teratomas, but they are still rare. Grabb sees a teratoma once every few years. And none, he said, would compare to Sam's.

Recent comments

It is so shocking but i think it is all sign of the end times

JOSEPH | Dec. 30, 2008 at 6:29 a.m.

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