Identical twin’s tissue donation gives rare sarcoma survivor a second chance

When Marian Fields first felt a lump in her back in 2012, she asked her twin sister Mary Jane to look at it. Her twin said it looked just like a cyst she’d had removed by a dermatologist 10 years earlier, and suggested Marian do the same.

So, Marian did. Three different times. And when the cyst grew back, she had it removed three more times by two additional doctors. The lump kept returning.

The reason: that “cyst” was actually plexiform fibrohistiocytic sarcoma, an aggressive skin cancer so rare that only about 150 cases have been confirmed in the United States since 1980, according to Keila Torres, M.D., Ph.D. It usually strikes young people between the ages of 2 and 22. Marian was 61 the first time she noticed it.

“Given the rarity of this cancer, I consider it an orphan disease,” Marian says. “I was surprised that anyone would agree to treat it. But MD Anderson deals with the unusual. That’s why we came here.”

Identical twin proves the ideal tissue donor

By the time Marian saw Jesse Selber, M.D., and Torres here in March 2017, her back was a mess. There were several open wounds near her backbone, and removing the tumor would require a tissue graft larger than Marian’s petite frame could provide.

“We didn’t realize how extensive or how deep it was,” Marian said. “It was more invasive than we’d anticipated.”

That’s when her twin sister stepped in — and offered herself as a tissue donor. “Marian and I are perfectly identical,” Mary Jane notes. “It’s just not immediately obvious, because I had a rare pituitary tumor years ago that caused a lot of changes to my appearance.”

Unusual sarcoma calls for unusual treatment

Testing soon proved Mary Jane’s assertion: she was a perfect genetic match for her sister. So on June 30, during a marathon 14-hour surgery, Selber and his team removed a large section of skin, tissue and blood vessels from Mary Jane’s abdomen and used it to cover the wound left in Marian’s back by the tumor Dr. Torres removed.

“I didn’t expect that much tissue to be taken,” Mary Jane admits. “But it was my body and my choice. I just think of it as having the world’s largest tummy tuck.”

Twins’ recovery continues

Thanks to their doctors, nurses and other members of their care team, both twins continue to recover from their respective surgeries. Mary Jane must refrain from sitting up straight for a while so she doesn’t tear her sutures. And Marian must spend most of her time lying face down, so her wound will heal properly. But the sarcoma survivor’s back is pain-free for the first time in more than two years, and today, she shows no evidence of disease.

“I’ve never seen anything like MD Anderson,” Marian says. “I truly feel cancer-free for the first time. Dr. Torres did a phenomenal job of cleaning it all out, and Dr. Selber did an incredible job of putting me back together.”

Making good on a promise

Marian is also incredibly grateful to her sister. “Her surgery was much harder on her than mine was on me,” she says. “But it gave me a quality of life that I wouldn’t have had without it.”

Yet Mary Jane insists that what she did is not noble. “If you were a twin, you’d understand,” she says. “It’s just what you do. And once all the swelling goes down, it will all be worth it.”

The one thing that retired teacher Mary Jane asked of her sister as a part of the deal was a promise to learn another language.

“I had the tissue to give and I’m healthy,” she says. “I told her I could do it and I did it. Now she’s got to learn French.”

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