The Tri-Service General Hospital
Shuang-Ting Pu is a 5-year-old girl from the mountaineous regions of northern Myanmar.She was born with congenital hemangioma of the tongue, and as she grew older, it became three times the size of an average girl’s tongue causing her to involuntarily extend and expose her vascular tongue repeatedly. With such an abnormally large tongue, not only is Shuang-Ting’s appearance affected, but her daily life is greatly altered including sleeping and speaking. Moreover, Shuang-Ting often accidentally bites her tongue to cause massive bleeding into her mouth. Therefore, she has spent her whole life taking many trips down to the Emergency Department for blood transfusions required after major blood loss, which further causes malnutrition and anemia. This congenital anomaly of the tongue has caused Shuang-Ting to frequently miss school along with a burden on the family in terms of paying for medical fees. In order to receive any possible treatment for this lethal and complicated disease, Shuang-Ting’s mother has attempted to seek help from Thailand’s Bangkok Hospital Center.
However, due to the severity of the disease, no doctor had been willing to operate.
In August of 2014, the medical team of the Taiwan Root Medical Peace Corps visited Lashiao, Burma for medical service, where they came across Shuang-Ting Pu. After returning to Taiwan, the Taiwan Root Medical Peace Corps placed a tremendous amount of effort to bring Pu and her family to Taiwan for further treatment. In May of 2015, Pu was able to fly to Taipei under the supervision of her mother and her aunt, and was admitted for hospitalization at the Tri-Service General Hospital under the care of Dr. Shiao-Ping Lee. Following a series of examinations including Magnetic resonance angiography (MRA), Pu was confirmed to have an abnormal vascular lesion occupying the right side of the tongue which extends to the floor of mouth measuring 10cm in length. Moreover, both sides of her tongue were found to have an abnormal increase in width of blood vessels. Therefore, angiography combined with bilateral embolization of the lingual arteries was performed on May 21, 2015. Post-operative imaging showed localized cerebral infarction which implied possible stroke, but Pu showed no obvious abnormal neurological reactions.
After the initial treatment, blood vessel volume and pulsation decreased, but Pu complained of intermittent headaches and pain of tongue. On June 4, 2015, the oral maxillofacial surgery team consulted the departments of radiology, anesthesiology, pediatric surgery, pediatric neurology, otolaryngology, rehabilitation, plastic surgery, and more including therapists, pharmacists, nutritionists, social workers and team of International Medical Care Center for hospice shared-care. On June 6, 2015, excision of the hemangioma and local flap reconstruction surgery was completed under general anesthesia. Once the wound healed, Pu was finally able to eat, speak, and smile like a normal child.
Under the unconditional care of the medical care team, Pu was able to return to Myanmar after recovering fully. Pu and her family are very grateful to the Taiwan Root Medical Peace Corps, Ministry of Defense, Ministry of foreign affairs, and in particular to the director of the Oral Maxillofacial Surgery department of Tri-Service General Hospital, Dr. Shiao-Ping Lee for her complex treatment.