Merceline A., 16

Merceline is a 16-year-old girl living with both parents. Her mother earns a modest income from selling vegetables, while her father works as a handyman. She enjoys attending church and singing and dreams of becoming a nurse. Merceline was identified during an outreach by Awasi Mission Health Centre and later directed to the facility by a Helpster volunteer because her family could not afford the required scans. Merceline has had a progressively noticeable swelling on the left side of her face for about five years, occasionally associated with pain. Although her vision remains normal, the swelling extends around the eye and causes the eyelid to cover it. The lesion is generally non-tender but causes considerable discomfort, facial heaviness and difficulty comfortably opening the affected eye. Its size and location also interfere with her appearance and everyday activities. On examination, multiple palpable cystic areas were noted. Following review by a maxillofacial surgeon, a head CT scan was recommended to establish the extent of the lesion and guide further management. She was subsequently diagnosed with cystic hygroma.

Merceline was diagnosed with a cystic hygroma, a lymphatic malformation causing longstanding facial swelling and discomfort. The doctor recommended sclerotherapy with bleomycin under general anaesthesia (GA). This involves injecting bleomycin into the cystic spaces to cause them to shrink, while Merceline is fully asleep to ensure comfort and safe treatment. The procedure aims to reduce the swelling, improve function and appearance, and relieve discomfort. Her prognosis is favourable, although more than one treatment session and continued follow-up may be required.