• Neurology Patient Stories

    Small Bump becomes Big Problem

Caleb Ragaller and his familyWhat began as a small, painless bump turned into a grueling 9.5-hour surgery for 3-year-old Caleb Ragaller (now 6).

Caleb was born with a nasal dermoid cyst. Because superficial dermoid cysts are typically slow-growing and can be removed without complication, Caleb’s treatment plan appeared to be pretty straightforward.

“We would go in for normal checkups and our doctor would just tell us to keep an eye on it and let us know if there were any changes,” explains Tina Ragaller, Caleb’s mom. “We planned to have it removed once he got older for cosmetic reasons.”

But when Tina and her husband, Doug, took Caleb to a plastic surgeon, they found out the condition was more complicated than it seemed.

“After reviewing the CT scan, the plastic surgeon saw there was more involved than just a dermoid cyst,” says Tina. “It looked more invasive. He said that even with his 33 years of experience he didn’t feel comfortable removing Caleb’s. He felt there was more involved, so he referred us to Mayo.”

The Ragallers, who live in Ames, Iowa, drove to Mayo Clinic in Rochester, Minn., where Caleb was seen by Marc Patterson, M.D., child and adolescent neurology.

“We met with Dr. Patterson first to see if there was anything wrong with Caleb neurologically. There wasn’t. The cyst wasn’t affecting his movement or anything else, so then we had his MRI done,” says Tina.

That afternoon, Nicholas Wetjen, M.D., neurologic surgery, reviewed Caleb’s MRI results with the family.

“He said there was a cyst, but it was growing inside of Caleb’s skull,” recounts Tina. “At that time he said they would have to have an ENT physician take a look, too.”

The next day, Caleb was seen by Dana Mara Thompson, M.D., pediatric otorhinolaryngology. After being seen by Drs. Patterson, Wetjen and Thompson, Caleb was recommended for surgery.

“Dr. Wetjen and Dr. Thompson teamed up for the surgery,” remembers Tina. “Dr. Wetjen worked on more of the skull area, and Dr. Thompson did the nose part of the surgery. It lasted 9.5 hours. We were emotional. We were scared. It was one of the longest days of our lives.”

But it was worth the wait. Caleb’s surgery was a success.

The Ragallers returned to Mayo for a postoperative appointment three months later, and were given more good news. The surgeons had effectively removed the cyst, and Caleb would not need to return for further treatment.

Today, Tina happily reports that Caleb is a very healthy boy who loves to run around and play with his twin brother, Carson.

“Other than a scar down the front of his nose and one on his head, you would never know he went through all that,” says Tina. “The physicians did a phenomenal job and we were fortunate that we were close enough to be able to drive to the Mayo Clinic.”

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