For the first time since her surgery in April, a 15-year-old Vietnamese girl appeared before reporters, who were gathered at University of Miami/Jackson Memorial Medical Center. And this time, she was free of the horrific 12-pound facial tumor that had threatened to end her young life.
Now, according to the girl's doctors, Robert Marx and Jesus Gomez, her dream to attend school for the first time in her native country may be in sight.
Lai Thi Dao suffered for more than 10 years with a slowly growing tumor known as a Schwannoma. The non-cancerous tumor had gradually consumed the lower part of her face. And as it grew, normal tasks such as talking, eating, drinking and sleeping became increasingly difficult.
Fortunately for Lai, the International Kids Fund learned of her situation and made arrangements for the girl to come to the United States in April for surgery, which cost $107,000.
Dr. Phan Nguyen of Jackson Memorial Medical Center, translating for Lai's mother Tuyet Thi, said that the entire family is grateful for the procedure, which likely saved the girl's life.
"[Tuyet] is very touched by the whole experience," he said. "She said that she is very happy that the surgery went very well, and she says that she does not know how to say thank you to Dr. Gomez and Dr. Marx for saving her daughter's life."
"The first thing that she is going to do for Lai is send her to school," Phan said. "She is dying to go to school -- that has been one of her dreams since she was little."
Tumor Would Have Killed Girl
The unusual nature of Lai's tumor may only have been matched by the marathon 14-hour surgery required to remove the facial growth.
Once the operation was complete, doctors determined that the tumor weighed 12 pounds, 9.9 ounces -- about one-fifth of the girl's weight -- and may well have been the largest example of its type ever seen.
The tumor started out as little more than a cyst on Lai's tongue when she was 3 years old. At that stage, surgery to remove the growth would have been quick, cheap and relatively painless.
Vietnamese Girl Tumor Experience Rare
In fact, these tumors are sometimes seen in the United States as well, though they seldom grow larger than the size of a marble or golf ball before they are removed.
Because Dao had little access to medical care where she lived, however, the tumor went untreated.
Had she not received the surgery, said Marx, professor of surgery and chief of the division of oral and maxillofacial surgery at the University of Miami/Jackson Memorial Medical Center, "she would have died within a year after we first saw her."
The cause of death would have been suffocation, as the crushing weight of the tumor on her chest and lungs would have eventually made breathing impossible.
"The tumor would have continued to grow slowly and relentlessly, and she would not have made it past April or May of 2009," Marx said.
The surgery, too, had its fair share of risks. Gomez, an oral and maxillofacial surgeon at the University of Miami, said that the fact that the tumor had been growing for so long meant that it contained large blood vessels. During the surgery, he said, Lai bled out almost 60 percent of her total blood volume, which doctors had to replace with constant transfusions.
Now, doctors are planning for the next round of surgery on Oct. 10, which will replace the bone that the first surgery took away from Lai's lower jaw. Lai is currently missing about three-quarters of her lower jaw, and to help replace it, doctors will use a technique that involves harvesting stem cells from her bone marrow, which will then be used to regrow the bone needed to reconstruct her jaw.
"The most difficult part of the treatment is already done," Gomez said during the press conference on Monday. "While this upcoming surgery may involve some risk, it is not going to be as risky as the first one."
If the surgery to reconstruct Lai's jaw on Oct. 10 is a success, Marx said that a subsequent operation to add dental implants could take place as early as April 9, 2009.
"If we can get dental implants in, she'll be able to chew and eat close to normal."
A New Start, Free From Deadly Tumor
The best news, Marx said, is that the tumor will not recur. He added that Lai will likely be able to return to Vietnam in November, though the hospital is "trying to arrange for her to return for dental implants and her final physical therapy" some time in the future.
For now, a tracheostomy tube is still in place in the girl's neck to help her breathe. Marx said doctors will probably be able to remove this tube for good during the girl's next surgery.
"We are only keeping it in because of safety reasons," he noted. "If you take that out, she can drink anything you can drink and eat a soft diet."
And Lai is now taking the first steps toward socializing with others.
"She's extremely happy; she's a different person," Gomez said. "Once we remove the trachea tube, we expect that she will be able to start saying some words.
"A lot of her childhood was missed because of this. She is now more outgoing, happy every day, and she has an ability to interact with others."
The final step, Marx said, is getting Lai into the classroom she has yearned to join.
"Now we are looking to make that final step," he said. "To me, that would be the final benchmark -- for her to be able to go to school in Vietnam on Nov. 15.
"What we would like to see her do is get back into the lifestyle her village in Vietnam offers -- for her to be able to blend in," he added. "If she is able to do what her brothers and sisters do -- go to work, have a family -- that would be a great achievement. It's all possible."