Big transformation for a little girl (+pics)

ANDREW GORRIE/The Dominion Post

SPECIAL PATIENT: Caitlin Scott, 3, with surgeon Swee Tan, who will lead the operation to remove a massive birthmark from her abdomen.

Supplied

INSIDIOUS GROWTH: An X-ray showing the birthmark in two-year-old Caitlin Scott's body.

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Caitlin Scott has always lived with her "lump".
But after delicate surgery the massive birthmark will be no more.
Birthmarks

The little girl, who turns three next month, will undergo a four-hour procedure tomorrow led by Hutt Valley District Health Board director of surgery Swee Tan.

In what is believed to be the first operation of its type in New Zealand, surgeons will cut through Caitlin's abdomen to remove the birthmark - known as a venous malformation - which lies beside her diaphragm, liver, kidney and bowel.

The vascular birthmark, essentially a sac of blood, is about 25 centimetres in size and expected to weigh at least two kilograms.

"This is probably the biggest I've seen in New Zealand," Dr Tan said.

Wellington Hospital paediatric surgeon Toni-Maree Wilson will join Dr Tan and a team of specialists and nursing staff to remove the lump, which had expanded with Caitlin rather than grown in size.

After removing the birthmark, surgeons will use a muscle from Caitlin's back to repair the abdominal hole left. Existing skin will be grafted over the top.

Caitlin first had surgery to remove part of the malformation at 18 months, but has suffered an increasing number of bleeding episodes and has needed regular blood transfusions. "It could potentially become life-threatening. We think we can do this surgery safely now," Dr Tan said.

Caitlin flew up from her home in the Dunedin suburb of Concord yesterday with her parents, Cheryl and Gavin Scott.

Mrs Scott said it was hard to believe Caitlin would no longer have what they affectionately referred to as her "lump".

"It's just been part of her. She's never really questioned it.

"You don't really realise how big it is till you see it sitting there. It's huge."

Caitlin understood she was to have an operation, which Mrs Scott said she and her husband were both "scared stiff" and excited about.

Finally being able to buy clothes that fitted Caitlin would be one of the biggest thrills, she said.

Venous malformations affect 1 per cent of the population, but most can be treated by injecting alcohol into the birthmark to shrink it.

Because of the size of Caitlin's, however, "it would take forever", Dr Tan said.

BIRTHMARKS

What is a venous malformation?
A type of birthmark affecting veins in certain parts of the body. A molecular defect causes a deficiency in the blood vessel walls, leading to weakening and a "blowout" of the vessels.

Where are the birthmarks found?
On any part of the body, though usually in just one place, such as an arm, face or torso. They can involve multiple parts and can vary in size. The birthmark usually empties when the affected part is elevated.

What about other birthmarks?
Venous malformations are the second-most-common type of vascular birthmark. Strawberry birthmarks are the most common and are usually successfully treated with steroids. Port-wine stains (capillary malformations) are also common birthmarks and generally do not require additional diagnostic testing or treatment. Pigmented birthmarks are another common form and are linked with a higher melanoma risk.