For three years, 12-year-old Janet Sylva from Gambia lived with a rapidly growing benign tumor in her jaw. The mass eventually reached the size of a cantaloupe (or small melon) and weighed approximately 6 pounds (2.7 kilograms). It severely distorted her face, made speaking and eating solid food nearly impossible, and increasingly obstructed her breathing. Doctors feared she might not survive another year without intervention.

Local medical resources in Gambia and neighboring Senegal were unable to handle the complex case. Janet stopped attending school and often covered her face with a scarf to hide the growth. In 2016, after international outreach, Staten Island oral and maxillofacial surgeon Dr. David Hoffman learned of her situation and coordinated care. The Global Medical Relief Fund arranged transportation, visas, housing, and support so Janet and her mother, Philomena, could travel to New York.

In January 2017, a multidisciplinary team at Cohen Children’s Medical Center (part of Northwell Health) in New Hyde Park performed a complex, roughly 12-hour operation. Led in key parts by plastic surgeon Dr. Armen Kasabian, the surgeons removed the massive tumor and immediately reconstructed Janet’s lower jaw using a vascularized segment of bone (fibula) taken from her own leg, along with associated soft tissue and blood vessels. Advanced 3-D imaging and virtual surgical planning helped guide the precise procedure.

The surgery was successful. Janet recovered steadily, regained the ability to eat, speak, and smile freely, and showed a bright, outgoing personality that had been constrained by her condition. Before returning home to Gambia, she expressed her dream of becoming a doctor so she could help others as the medical team had helped her. Her case highlighted both the life-threatening impact of untreated maxillofacial tumors in resource-limited settings and the power of international collaboration and volunteer surgical care.

Sources

• Associated Press and Northwell Health / Cohen Children’s Medical Center reports (March 2017).
• Newsday, CBS New York, NY1, and related coverage of the surgery and recovery.
• Statements from Dr. David Hoffman, Dr. Armen Kasabian, and the Global Medical Relief Fund.