Editor's note: This popular story from the Daily Briefing's archives was republished on Jan. 27, 2021.
Hector Hernandez's friends used to joke that he had a "beer belly," but as Hernandez's belly grew larger and larger, he grew concerned that something might be wrong.
'I just thought I was fat'
For some time, Hernandez had noticed his stomach was getting bigger while the rest of his body was getting thinner. He also started struggling with heartburn and constipation and often had difficulty breathing.
Eventually, he reached 300 pounds. "I wore big jackets to try to cover up, but it was very noticeable," he said. Initially he didn't think much of his size. "I just thought I was fat," he said.
And at least one doctor seemed to agree. The physician told Hernandez that some people carry weight in different ways than others.
But as time passed, Hernandez became convinced weight gain wasn't the sole problem. He tried a plant-based diet to lose weight, but saw no progress, and his stomach began to feel "heavy" and "hard" to the touch. So Hernandez sought out a second opinion, and eventually was referred to William Tseng, a surgical oncologist and assistant professor at the Keck School of Medicine at the University of Southern California.
A shocking diagnosis
After some initial testing, Tseng diagnosed Hernandez with a retroperitoneal liposarcoma—a rare cancerous tumor that forms in fat cells.
"I was kind of in shock," Hernandez said.
Tseng performed six-hour operation to remove the large tumor. According to Tseng, these tumors are typically between 20 and 30 pounds—Hernandez's was 77 pounds. "This is probably the largest one I've removed," Tseng said.
Fortunately, Tseng said the tumor had spared Hernandez's major blood vessels and organs but had damaged one of his kidneys beyond repair. "The tumor swallowed it up, basically," Hernandez said. "It wasn't functioning anymore."
The mystery behind liposarcomas
Tseng warned Hernandez that liposarcomas often come back, and if his does, it could be more aggressive. While surgery is generally a safe way to treat the tumors, liposarcomas present a bit of a medical mystery. Doctors aren't entirely sure why liposarcomas form or how they can stop them.
"We don't have anything that can prevent it at this point," Tseng said. He added that this form of cancer could use more research. "We desperately need something better than surgery," he said.
Hernandez does not need to receive chemotherapy, but he will have to undergo CT scans every four months to make sure the tumor does not come back.
Overall, however, Hernandez said he feels "totally different" with more energy. He said he's "still not 100%," but around "90%" back to normal (Bever, Washington Post, 11/27/18; Caron, New York Times, 11/29/18).