Rare venous lymphatic malformation — about 95% of lesion removed

Full treatment costs of about 90 million won covered

Thandolubanduzi is wheeled into the operating room on a hospital bed. [Provided by Severance Hospital]
Thandolubanduzi is wheeled into the operating room on a hospital bed. [Provided by Severance Hospital]

Severance Hospital has treated a 7-year-old boy from Eswatini who had been living with a growth the size of his face caused by a rare congenital condition, inviting him to South Korea for surgery.

The hospital announced Thursday that it had brought Thandolubanduzi Sinemphilo, 7, a citizen of Eswatini, to South Korea last month for the procedure. The boy has a venous lymphatic malformation.

Venous lymphatic malformation is a rare congenital condition in which abnormally enlarged blood vessels and lymphatic vessels form a mass. It occurs in roughly one in every 10,000 newborns.

Thandolubanduzi was born with a "microcystic" lesion, in which small cysts spread between muscles, nerves and blood vessels. The lesion was first detected on the left side of his neck when he was about three months old, but without treatment it grew until it covered his jaw and neck.

The family lives on a monthly income of about $125 earned by his stepfather, a truck driver, making treatment in Eswatini out of reach. The mass made it difficult for the boy to speak, and he struggled to socialize with peers or attend school.

His story reached Severance Hospital through a Yonsei University College of Medicine alumnus working abroad. After medical staff reviewed his test results and treatment conditions, they selected him for the Global Severance, Global Charity (GSGC) program, which invites patients from medically underserved countries for treatment. Severance Hospital covered the full cost of about 90 million won ($66,500).

Detailed examinations revealed that the lesion had spread deep into the healthy tissue of the jaw and neck. It was compressing the airway, pushing the windpipe to one side, and had invaded the muscles needed for swallowing, chewing and moving the neck. The hypoglossal nerve, facial nerve and external carotid artery were all encased by the lesion.

Professor Kim Da-hee (left), Thandolubanduzi and his mother pose for a photo before his discharge. [Provided by Severance Hospital]
Professor Kim Da-hee (left), Thandolubanduzi and his mother pose for a photo before his discharge. [Provided by Severance Hospital]

The larynx had also been pushed far from its normal position, making it difficult to secure the airway even before surgery began. The medical team spent about 40 minutes securing the airway and two hours on anesthesia and surgical preparation alone.

Kim Da-hee, the otolaryngology professor who performed the surgery, focused on securing the airway, minimizing external deformity and preserving the boy's ability to swallow and speak. The removed pathological tissue measured 15 centimeters wide and 10 centimeters long.

Kim removed about 95 percent of the total lesion. Some portions that had spread to the base of the tongue and oropharynx were left in place, given the risk of requiring reconstructive surgery and causing serious complications if removed.

The operation prioritized securing the airway and preserving the boy's ability to eat and speak as fully as possible, rather than removing every part of the lesion.

Severance Hospital coordinated care across multiple departments — led by otolaryngology and anesthesiology and pain medicine, with support from pediatric hematology-oncology, pediatric critical care medicine and pediatric infectious disease and immunology — to carry out the surgery and support his recovery. The team also consulted on sirolimus therapy to suppress the growth and recurrence of the remaining lesion.

"In South Korea, most cases are detected and treated in infancy, so it is very rare to see a case like Thandolubanduzi's, where delayed treatment allowed the lesion to grow to the size of his face," Kim said. "Rather than removing every part of the lesion, what mattered most was preserving his ability to eat, speak and live well going forward."

After returning to Eswatini, Thandolubanduzi will continue taking sirolimus and undergo regular blood tests. Severance Hospital has also coordinated with a hospital in South Africa to monitor his progress.

During his treatment, Thandolubanduzi said he hoped to become a doctor himself one day. "I want to become a great doctor, just like the one who treated me," he said.

Meanwhile, Severance Hospital invited a 10-year-old girl from the Philippines with myelomeningocele to South Korea under the GSGC program in December last year. Before surgery, protruding nerves on her back made it difficult for her to sit or lie flat, but she recovered well enough after the operation to sleep in a proper position.


woo@heraldcorp.com