It’s difficult at times to see the birthmark on Markus Lambert’s left leg.
Not because the dark brown skin abnormality is small — it’s about the size of two adult hands placed side by side.
But because Markus, 4, is often a blur as he dashes around his family’s Millcreek Township home.
“I love the Power Rangers,” Markus said as he ran with a Power Rangers action figure around the living room. “I have a whole box full of them.
Children are often born with birthmarks, but few of them have undergone seven surgeries — with an eighth one scheduled Sept. 28 — to remove them.
That’s because Markus’ birthmark is called a giant congenital melanocytic nevus. It’s basically a large mole, but it increases his risk for skin cancer and, to a lesser degree, seizures and developmental delays.
“I remember having a C-section to deliver Markus, looking down and seeing what looked like a wrestling knee pad around his left knee,” said his mother, Nicole Lambert. “It looked like a large bruise, all purplish, brownish and blackish.”
Unlike a bruise, the birthmark didn’t fade away.
Lambert and her husband, Corry, took Markus to see doctors at Children’s Hospital of Pittsburgh and the Cleveland Clinic.
They recommended that Markus undergo a series of operations to remove the birthmark.
“What you have is an incredibly large mole,” said Mark Hendrickson, M.D., a Cleveland Clinic plastic surgeon who has operated on Markus. “That much tissue gives Markus a higher risk of developing melanoma, so the goal is to remove as much of that tissue as possible.”
Cutting out Markus’ birthmark hasn’t been as simple as lopping off a mole, though.
Hendrickson needs healthy, normal skin to cover the wounds he creates by removing the birthmark tissue. So he implanted two skin expanders under the healthy skin on Markus’ leg.
“These are balloons that you fill slowly with saline to expand the skin,” Hendrickson said. “Over time, they give you extra skin to cover the wound.”
The surgeon can only remove as much birthmark as can be covered by the expanded skin, so the removal has gone slowly. Four years after the first surgery, two-thirds of Markus’ birthmark still remains.
The September surgery will remove up to another third of the birthmark, Hendrickson said.
After each surgery, Markus is bandaged from hip to ankle and told not to do anything to tear open his stitches.
“He does so well, but it’s tough for a 4-year-old boy not to run around and wrestle and do things like that,” Nicole Lambert said.
As a reward for going through all the surgeries, Markus went on a trip with his family to Orlando, Fla., in early August.
The Kids Wish Network paid all of the family’s expenses, including plane fares, theme park admissions, meals and a rental car.
“They even gave us spending money,” Nicole Lambert said.
A family friend convinced Nicole Lambert to apply to have Markus’ wish granted. They went to Orlando because Markus wanted to see the Power Rangers at Disney’s Hollywood Studios, part of Walt Disney World Resort.
Once Markus got to see his heroes in person, they asked him to show them his fighting poses.
“I got to do this one,” Markus said, thrusting his fist through the air.
“And this one,” he said, crossing his arms.
Kids Wish Network may have granted Markus’ wish, but his prognosis is pretty good, Hendrickson said.
Removing most of his birthmark will reduce his risk of melanoma, though it will remain higher than the average person’s.
And Markus doesn’t show any signs of neurocutaneous melanocytosis, when pigment cells similar to those in his birthmark are found in the spinal cord or brain. It can cause seizures, developmental delays and — in rare cases — death.
The cells don’t travel there from the birthmark. Instead, they remain in the spinal cord and brain from when the child was a developing embryo.
“A child’s risk of NCM depends on how many satellite (birthmarks) he has and where they are located,” said Mark Beckwith, executive director of the Nevus Outreach Inc., a nonprofit nevus support and awareness organization. “Children with ones that cover their spinal cord have an increased risk.”
Markus’ only satellite birthmark is a small circle under his left ear.
“We could have an MRI done to see if Markus has any cells in his cord or brain,” Nicole Lambert said. “But unless he starts developing any symptoms, like headaches, there’s no reason to do it. They can’t remove those cells.”
Nicole Lambert said she knows how lucky her family is. She has grown close to the families of other children with the birthmarks who have died.
“So many kids have it so much worse,” Nicole Lambert said. “The surgeries are tough, but he’s doing so well.”
Tags: Disney World, Kids Wish Network, Power Rangers, Wish