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Struck by rare, complex sinus and brain tumors, June needed multi-disciplinary care

A dedicated, multi-disciplinary care team representing nine different medical specialties treated June’s skull-base tumors and helped her get back to what matters most.
June was treated by nine separate medical specialties at University of Minnesota Medical Center, but her care was streamlined and coordinated by dedicated staff.

When common symptoms turned into a complex diagnosis for June, finding the expertise she needed became critical. 
A local, dedicated care team representing nine different medical specialties treated June’s skull-base tumor and helped her get back to what matters to her most—family, friends and her work as a parish nurse serving the homeless in Minneapolis.

Routine surgery reveals rare condition

When June was suffering from persistent sinus issues, her doctor recommended routine surgery. But the situation turned anything but routine when the surgery revealed a new problem: she was diagnosed with esthesioneuroblastoma, a rare tumor of the sinus cavity. Doctors also found a walnut-sized tumor in her brain. 

As a nurse, June has advised many patients not to jump to the worst-case scenario, but she found it hard to follow that advice herself. The diagnosis was life-changing, and would require uncommon expertise for treatment. Traditional surgery would require opening her skull to get to the tumors, but her ENT surgeon directed her to a University of Minnesota Health specialist who could perform a minimally invasive endoscopic procedure through the nasal cavity.

That physician is Otolaryngologist and Head-and-Neck Surgeon Emiro Caicedo-Granados, MD. He and Neurosurgeon Ramachandra Tummala, MD, collaborate in a skull-base tumor program, which allowed June to see both specialists in a single appointment and provided multi-specialty expertise for her complex condition. This collaboration also included physicians from oncology and radiation oncology who all work together to develop a care plan for each patient.

June was immediately put at ease by their teamwork, their warmth and their sense of humor. 

“They do research and are excellent scientists, but were warm and caring,” she said. “I felt secure.” 

There was a lot of information to process at that first appointment. June’s care coordinator, Jennifer Jankovic, was available to provide context, answer questions, order medications and help calm June’s anxiety. June needed care from a long list of specialists, including experts from otolaryngology, neurosurgery, dental health, ophthalmology, radiation oncology and anesthesiology. Jennifer’s ability to coordinate appointments between this wide array of specialists helped minimize June’s trips to campus both before surgery and for her follow-up care.

The power of collaboration

Teamwork is important to Caicedo-Granados. 

“It starts with the first phone call from the referring physician. The person who answers that call knows exactly where that patient should go and what is needed. People come to see me or Dr. Tummala, but behind us is this great team that makes everything go. We couldn’t do it without them.”

Learn more about our Otolaryngology Surgery services.

Before the first appointment, Caicedo-Granados and the team gathered lab and imaging results and consulted with other specialists, which enabled them to have a treatment plan ready to discuss with June at her first appointment with June. Working with colleagues across departments ensures that “the imaging is correct, the pathology is correct and that we’re not missing anything. That all options have been considered,” Caicedo-Granados said.

June’s journey continues

On the day of June’s ten-hour surgery, staff updated her family in the waiting room every hour. When the operation was over, the surgeons emerged with good news: The sinus tumor was malignant but the brain tumor was benign. June would make a full recovery. 

June spent four days recovering in the hospital, about half the time that would have been required with traditional surgery, then had six weeks of radiation treatment. Her follow-up care will continue for up to ten years, to ensure any returning cancer is caught early.

“One of my greatest comforts is the security I have in the care that was provided,” June said, reflecting on her journey. “A path had been laid before me and I had an expert team to guide me through.”

That path now traveled, June was able to return to her work helping others. 

“I haven’t saved the world yet,” she says.” There are still homeless people in downtown Minneapolis. The best has been done to help me. Now I have things I need to do.”