No matter how hard Linda Rittenbach of Redmond, Ore., exercised and dieted through the years, she just couldn't seem to lose her excess weight.
Finally, after three surgeries earlier this year, the 58-year-old lost 140 pounds — in the form of two previously undetected tumors that were extracted from her midsection.
Removed between March and May, her tumors, known as liposarcomas, had been growing for an estimated 15 to 20 years.
They were discovered during exploratory surgery when Rittenbach was unable to fit into the scanner after being rushed to the ER with flu-like symptoms. In addition to the tumors, doctors found that her appendix had burst.
"Mom didn't have time to react to the news right away," her daughter, Katie Jones, told ABC News. "She was very depressed and preparing to die when she got the news that they had taken out the first one and that the doctors would have to take out the other one later. She planned for her death in case she didn't make it out of the third surgery."
After the initial surgery in the ER, Rittenbach was sent to Oregon Health and Sciences University.
"There they prepared her for a 20-percent chance of survival with the surgery or go home and die in two months," Jones said. "She talked with the family and decided to go for it."
After a 13-hour operation, Rittenbach was sent home. She had a third surgery at St. Charles Medical Center-Redmond.
Not Your Average Weight Problem
While it took Rittenbach many years to be diagnosed, Jones said that she had long suspected that her mother had a problem that would not be solved by diet and exercise.
"I told my mother 10 years ago that her stomach was too hard for it just to be fat," she said. "Ten years ago; when she could still get on the floor and do sit ups there was a little bump the size of a softball that would stick out just a little, when she would sit up.
"I knew it was a tumor years ago but trusted the doctor because he went to school many years and he should know better than me."
Jones blames the lack of time spent by doctors with her mother as well as their failure to get a second opinion for the growth of the tumor.
Citing both patient privacy concerns and disruption to patient care from media attention, Dr. George Tsai, who performed the third surgery at St. Charles Medical Center-Redmond, declined to be interviewed at length for this article.
But Tsai said that the take-home message from this case was that these kinds of tumors will grow differently in different patients, and other concerns in Rittenbach's case may have led doctors to overlook the possibility of a massive tumor.
"It's a very rare tumor," he said. "It normally isn't allowed to get this big."
Oregon Health and Sciences University said through a spokesperson that while they wished Rittenbach well and are glad to hear of her progress, they did not think it would be appropriate to comment on her case.
Sam Yoon, a surgical oncologist at Massachusetts General Hospital and a specialist in liposarcomas, said that tumors can often grow for a long period of time and become quite large.
"I've had patients who have had the disease for 20-some years," he said. "It's not unusual to see very large liposarcomas in the abdomen. … People think they're gaining weight."
But at the same time, Yoon said, that weight-gain often looks very unusual. The largest he has ever removed was 50 pounds, and that was from a 300-pound man. Yoon said he had never heard of a tumor as large as this one.
Rittenbach is in recovery, and while she still has cancer — a situation Yoon said is to be expected given the difficulty in fully removing this type of liposarcoma — she has been more active and has lost weight, according to Jones.
Rittenbach is down to around 200 pounds and is "dropping off like every day," Jones said.
"She's been positive ever since. She just wants people to know there is always hope for a future; no matter how bleak, there is always hope."