A doctor in Boston says he and a team of specialists can treat a 10-year-old Vietnamese orphan who travelled to Canada seeking medical help for a large growth on his face, but was turned away by a Toronto hospital.
Dr. John Mulliken, a plastic surgeon with a specialty in vascular anomalies, said he has reviewed Hoang Son Pham's medical files and is confident he can shrink the football-size growth.
"He would still have some distortion, but it will be shrunken down to 10 per cent of what it is now … and he will look much, much, much better," Mulliken said in an interview from his office at Children's Hospital Boston.
"We can do it, but think of all the logistics. It's going to be costly."
It's not clear how much the procedures would cost, but Mulliken said officials were looking at endowments and other pools of money that could be used to cover some of the expenses.
The physician said a team of plastic surgeons and interventional radiologists were proposing a lengthy course of injections called sclerotherapy, to be followed possibly by surgery to correct some of Son's facial distortions.
If his caregivers agree to the tentative plan, the procedures would likely take a year or more to complete, with the boy travelling from his temporary home in Halifax to Boston every six to eight weeks for treatment.
Mulliken said all of the doctors on the team have agreed to do the work for free, but there are associated costs that would need to be covered.
"I wish we could do it for nothing because it would be great to help the little guy and it's quite a dramatic case -- any doctor would say, 'Gee, this is why I'm a doctor,'" he said.
Son arrived in Canada last summer after an official with the Children's Bridge Foundation, an Ottawa-based charity, found him at a Vietnamese orphanage where he had been living since the age of three.
Doctors at the Hospital for Sick Children in Toronto agreed to review his case after the charity raised about $200,000 for his travel, care and medical needs.
Specialists there spent four months conducting medical tests and assessing their findings, only to announce earlier this month that it would be better for the boy not to receive any treatment.
They said there were risks to the procedure and that the growth — a birthmark that has grown since Son was born — was not life-threatening.
Growth could be life-threatening: doctor
In Boston, Mulliken said he was mystified by the decision.
He said the growth could eventually encroach on Son's airway or diminish his blood's ability to clot.
"I don't know what their thinking was," he said. "It kind of boggles the mind. He's a deserving little boy and it's a challenge and it's going to take a lot of work."
Olwyn Walter, vice-president of the foundation, said she is optimistic treatment will be made available for Son in either Boston or New York, where a doctor has also suggested he could reduce the growth.
She received a letter from the Boston hospital Tuesday briefly outlining the treatment, and is busy working to extend the boy's Canadian visa and get permission to travel to the United States.
"The good news is that it looks like treatment is possible," she said from her Halifax home Tuesday.
Following the testing in Toronto, Walter brought Son and his nanny to Halifax, where they are living with her two daughters and husband while the boy goes to school and studies English as a second language.
Walter said she has about $170,000 left from the fundraising efforts.
Mulliken said sclerotherapy would involve injections of liquids that could gradually reduce the size of the growth. But there are risks associated with sclerotherapy, including a breakdown of the skin, nerve damage and scarring.
But Mulliken said there are risks in doing nothing, since the sponge-like malformation will continue to grow.
"He's going to get slowly worse," he said, adding that he's treated patients with similar, but smaller growths.
"By the time he's a teenager or young adult, that will be bigger and it'll be hanging down and he is at risk … So, even if he had necrosis or loss of skin and ended up with some scarring, he'd be much better off."
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