Girl from Gambia, 12, Returns Home with New Smile After Six-Pound Tumor Removed

Posing together before the trip home to Gambia are (from left): Phillomena; Janet; Elissa Montanti; translator About Diakhate; Dr. Armen Kasabian; and Dr. David Hoffman.

As she prepares for the return trip to Gambia next week, 12-year-old Janet Sylva is looking forward to her future with a new smile, thanks to a small army of doctors, surgeons, nurses and friends who all joined forces to organize the surgery that finally removed a deadly, six-pound benign tumor from her jaw.

Janet’s story began about three years ago in West Africa, according to her mother, Phillomena Sanyong, who explained during a return visit Cohen Children’s Medical Center that the tumor first became noticeable at that time. The concerned mother hoped that it would disappear on its own, and became distressed when the situation worsened.

“Janet’s personality began to disappear,” said Phillomena. “She became withdrawn from her friends. Now, she is a different person. I’m just so grateful to everyone who made this huge change possible.”

Janet’s journey to Cohen began after the child was brought to a hospital in Sengeal. Unable to provide treatment, doctors there reached out to international health groups, including Healing the Children, whose Florida chapter posted Janet’s picture on their website.

Luckily, that photo was seen by David Hoffman, MD, Director of the Division of Oral and Maxillofacial Surgery at Staten Island University Hospital. Dr. Hoffman responded by saying that he would try to assemble a team to treat the child.

At that point, Dr. Hoffman reached out to Elissa Montanti, president of the Global Medical Relief Fund, a Staten-Island based charity that arranged for transportation, housing and travel visas for Janet and her mother.

With the logistics in place, Dr. Hoffman began to analyze the details of this very complex case.

“Nobody knew that a tumor could reach that size,” said Dr. Hoffman. “It’s really due to the team effort of all the doctors, surgeons and nurses here at Cohen, who agreed to come together to treat Janet.

“This was a girl who was literally trapped in her own body. Had this tumor been left untreated, Janet would certainly have starved to death. The size and location of the tumor were affecting her ability to breathe and eat.”

After thanking Armen Kasabian, MD, System Chief, Plastic Surgery, North Shore University Hospital for his assistance during the surgery, Dr. Hoffman remarked on the transformational effect on Janet’s personality.

“This was a girl who came to us with a scarf covering her neck,” he said. “She wouldn’t look us in the eye, and she wouldn’t remove the scarf. Now, she’s running around, playing with other children, eating and smiling. She is coming back to herself.”

The 12-hour surgery took place on January 16, 2017. Prior to the operation, the team of surgeons decided to have a “virtual surgery,” during which the tumor was visualized on a computer and then subtracted or removed from the facial skeleton. This technology allowed for surgical guides to be made that eliminated significant amounts of time and guesswork.

The complex surgery called for the removal of the tumor (which had grown to the size of a small melon from the mandible (jaw) and immediate reconstruction with a vascularized graft from her fibula (lower leg bone). The bone was harvested with some of its attached muscle, along with the artery and veins that supply its blood, and then connected to arteries and veins in the head and neck area.

After the successful surgery, Janet remained at Cohen for additional monitoring. She then began the rehabilitation phase of her treatment – the daily tasks of breathing correctly, speaking and eating needed to be re-learned.

Speaking through a translator (her native tongue is Wolof), Janet thanked all the “angels” who helped organize her life-saving surgery. Thanks to them, she said, she looks forward to returning home and hopes to attend school to learn how to be a doctor.

And the scarf that she refused to remove from her neck?

“I’ve already thrown it away,” said her grateful mother.

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Michelle Pinto                                        
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