A retired auto parts salesman and stock car mechanic, 69-year-old Tony DeGange always has had a head for engines. But he never envisioned the possibility of actually using something from inside his head to power one of his motorized creations.
Thanks to a souvenir he received after Mayo Clinic surgeons successfully removed his grapefruit-sized brain tumor, that's now one of the pursuits the Valdosta, Georgia, native is considering.
"I'm working on a go-kart engine for the son of a friend of mine, and I think I can use it as a filter for the carburetor," Tony says, of the piece of titanium mesh that was placed after surgery to serve as a temporary seal between his skull and brain. "We'll give it a try and see how it goes."
For years, Tony was aware of a bump on his head. He never paid much attention to it, though, until his barber pointed out that it seemed to be changing. "He said: 'Tony, I think it's growing. You better have it looked at,'" Tony recalls.
Tony saw a local neurologist and neurosurgeon, and they confirmed it was more than a bump. Tony had a meningioma — a tumor that forms on membranes that cover the brain, just inside the skull. Many meningiomas are slow-growing, and most are not cancerous.
Wanting another opinion, Tony visited a different medical center. The treatment recommended there was not appealing. "(The surgeon) described a technique that would leave me with an open wound for quite a while," Tony says. "I just thought there had to be something better."
"If something wasn't done, he would definitely have had mobility deficits in his face, arm and leg."Rabih Tawk, M.D.
On the advice of a neighbor and encouragement from his wife, Maxine, Tony decided to visit Mayo Clinic in Florida. "I had always heard that Mayo Clinic was the place to go, and our neighbor had a terrific experience there, so I thought we should give it a try," Maxine says. "I'm glad we did."
It was a timely decision. Tony's care team at Mayo Clinic found that his tumor not only was large, it was invading critical areas of his brain. Soon it would have a serious impact on his health and quality of life.
"Tony's tumor had grown through bone, invaded brain tissue, and it was pressing on very important areas of his brain that affect motor function," says Rabih Tawk, M.D., a neurosurgeon who was part of Tony's Mayo care team. "If something wasn't done, he would definitely have had mobility deficits in his face, arm and leg."
Given the complexity of Tony's tumor, Dr. Tawk and other members of the team in Neurosurgery decided to bring Tony's case to Mayo Clinic's Neuro-Oncology Program board. The group includes physicians in Medical Oncology, Radiation Oncology, Radiology, Pathology and other disciplines, all of whom specialize in the treatment of brain tumors. Together, they developed a multistep treatment plan for Tony that would include surgery and radiation therapy.
The plan also would involve skull reconstruction that included a customized titanium implant to preserve the original shape of Tony's skull. Sarvarm TerKonda, M.D., a Mayo Clinic reconstructive and plastic surgeon, joined the care team to address Tony's appearance.
"My big concern was whether Tony's tumor had invaded his scalp," Dr. TerKonda says. "It was great news when we reviewed his scans and realized it hadn't. That way, we could save his entire scalp, use it for reconstruction, and his hair would grow back."
Tony's surgery was scheduled for May 8, 2018. That day, it took surgeons eight hours to remove the tumor and then implant the mesh to protect his brain from swelling. Tony went home three days later. He returned to Mayo Clinic in July for the reconstructive surgery. In August, Jennifer Peterson, M.D., a Mayo Clinic radiation oncologist, used a gamma knife procedure to remove a small bit of tumor that remained.
"Here I am — good as new and happily enjoying retirement."Tony DeGange
By September 2018, Tony was sporting a full head of hair and tinkering with his souvenir in the mechanical shop where he works on his friend's go-kart engines.
Now, more than a year later, when Tony returned to Mayo Clinic for a visit to check the status of his tumor, he received nothing but good news. There are no signs that the tumor returned, no side effects from the surgery and no visible scars. "Here I am," Tony says. "Good as new and happily enjoying retirement."