For most of her life, 15-year-old Lai Thi Dao has lived a life that many teenagers could not comprehend.
For the past 10 years, a slowly growing tumor has gradually consumed the lower part of the Vietnamese girl's face. As it grew, normal tasks such as talking, eating, drinking and sleeping became increasingly difficult.
Lai has never been to school. And since the tumor is heavy and located on one side of her body, even walking has become a challenge.
Tragically, the growth, known as a schwannoma tumor, started off as little more than a cyst on Lai's tongue. At this stage, the surgery to remove the growth would have been quick, cheap and relatively painless. But Lai had little access to medical care where she lived, leaving the tumor to continue to grow.
Now, a team of surgeons at the University of Miami is preparing for a marathon 10-hour procedure next Tuesday intended to cut away the growth, which now weighs an estimated 10 pounds and could be the largest recorded tumor of its kind reported in the medical literature.
The good news: the surgeons believe that once the tumor is successfully removed, it will not likely return. And they say they are hopeful that the operation will give Lai a chance at a more normal life.
"We see these in the United States. But when we see them, they are marble- or golf-ball-sized," notes Dr. Robert Marx, professor of surgery and chief of the division of oral and maxillofacial surgery at the University of Miami/Jackson Memorial Medical Center. "If we didn't get to this tumor in a reasonable time, it would have choked off her airway. In six months to a year, this could have ended up with a tragedy due to airway obstruction."
"If everything goes well, she's going to look very decent from an aesthetic standpoint and the whole tumor is going to be removed," said Dr. Jesus Gomez, oral and maxillofacial surgeon at the University of Miami/Jackson Memorial Medical Center, in a press release Tuesday. "This is the surgical removal of a tumor, but we will be doing reconstruction at the same time."
Considering the magnitude of the surgery, it is little surprise that the procedure carries risks as well. One of the most crucial facets of the procedure is controlling the bleeding from the many blood vessels that supply the tumor.
"Our biggest concern is the huge number of blood vessels going into the tumor," Marx says. "We estimate the tumor weighs about 10 pounds, so it's like a newborn baby."
"We saw vessels that were over an inch in diameter," Gomez adds. "So the bleeding complications that we can have on the operating table are potentially very big. We are setting up a huge team in order to accomplish this in a safe manner."
Still, the nature of the surgery will allow Marx and Gomez to perform a significant amount of reconstructive work as the tumor is removed. The surgeons will be faced with the considerable task of realigning Lai's jaw and reconstructing the bone and soft tissues that have been distorted by the massive growth. Marx says the techniques they plan to use will allow them to hide and minimize scars, allowing for a better appearance along with better function.
"We expect her to look better, speak better, swallow better and, by extension, eat better," he says.
Despite what promises to be an extensive surgery, those around Lai say that she is handling the experience well.