In March 2024, 17-year-old Brecken Peterson was feeling stuffy and having a hard time breathing out of his nose. Determined to get an answer, he continued to take himself to the doctor at the walk-in clinic at least once, usually twice a month. The Williston, North Dakoka resident was treated for allergies and sinus infections.
Then he had a five-hour nosebleed, which resulted in a referral to an ENT specialist in Billings, Montana. The initial appointment was with the nurse practitioner, who did a scope and told Brecken he had a deviated septum, probably from playing sports. He also thought he was experiencing allergy symptoms.
A week later, Brecken’s mom Nicole received a call from the clinic asking her to bring Brecken back for a CAT scan. This time they met with the head of the clinic, Dr. Joel Dunn, who performed an in-office CAT scan. As Dr. Dunn suspected a juvenile nasopharyngeal angiofibroma (JNA) tumor, he told the family to take Brecken to the neuroscience center in Billings for an MRI and MRA for confirmation.
The tests confirmed Dr. Dunn’s suspicion that Brecken had a non-cancerous tumor that developed in the nasopharynx, the space behind the nose that connects to the mouth. It is the most common benign tumor of the nasopharynx, but it is still rare. There are only about 50 new cases a year in the U.S.
Dr. Dunn’s recommendation was surgery. Nicole’s first question was, “Who is the best?” His response was, “If it was my child, I would be going to Pittsburgh.”
Nicole did not think twice; she had Dr. Dunn send paperwork to Dr. Eric Wang’s office for a referral; Dr. Wang is Chief of Rhinology at UPMC and Executive Vice Chair of the Department of Otolaryngology-Head & Neck Surgery.
“Dr. Wang’s office was amazing and helped set up a phone conference for an initial consultation due to the distance we would have to travel for medical care,” Nicole said. “The phone conference with Dr. Wang made us feel at ease and that Brecken was in good hands. Dr. Wang’s staff not only helped with the coordination of appointments, but also with a referral to the Family House.”
On November 9, the Petersons flew into Pittsburgh to get settled into the Family House and prepare for appointments on November 11. On that day, Brecken had new MRIs, and the following day, new CAT scans. He also Dr. Paul Gardner, MD, and Lucille Lewis, PA-C.
On the 13th, the family watched a Pittsburgh Penguins game before admitting Brecken to the hospital the next day. The procedure to embolize his tumor went well. On the 15th, Drs. Wang and Gardiner removed the JNA tumor. After two days in the NICU, Brecken was released to the Family House, where he continued his recovery.
At the post-operative appointment with Dr. Wang on the 22nd, he gave the family his blessing to fly home. “As nice as everyone was in Pittsburgh, it was a relief to get home and sleep in our own beds,” Nicole said.
Nicole “absolutely does not regret” making the trip to Pittsburgh; she said it was worth it. “In fact, Brecken’s dad only wanted a UPMC t-shirt for a souvenir, as he was that happy with the care,” she added.
Dr. Wang said that juvenile angiofibromas can be very challenging tumors because of their significant bleeding and growth patterns into difficult to reach spaces in the skull base. “We are fortunate to have a great team at the UPMC Center for Cranial Base Surgery, a joint venture between the Departments of Otolaryngology and Neurosurgery,” he continued. “Together we have tackled a large number of these difficult tumors from patients throughout the United States and I am thrilled that Brecken did so well. It was a privilege to help him and his family.”
In six months, the Petersons will return to UPMC for a follow-up with Drs. Wang and Gardner. Brecken will see Dr. Dunn in the interim to ensure he is continuing to heal. “We are hoping to treat the follow-up more like a vacation and see all of the great things Pittsburgh has to offer,” Nicole said.
When asked what she would say to other parents who might be in a similar situation, Nicole said, “I would tell them that their child is in the best possible care. Find peace that Dr. Wang and Dr. Gardner will give your child the freedom to breathe once again.”