A baby who developed an enormous tumour on his lung while in his mother's womb was operated on before he was born - and has lived to celebrate his second birthday.
Elijah Leffingwell, now two, developed a tumour that was three-and-a half times larger than his head while still inside his mother April's womb.
The tumour was spotted at April Leffingwell's 20 week scan, and surgeons told her that the tumour, which was crushing Elijah's organs, would surely kill him if they didn't perform a rare procedure to remove it before he was born.
"He would have died," Elijah's primary surgeon, Dr. Scott Adzick of the Children's Hospital of Philadelphia, told The Daily Signal. "No question. He would have died if the operation were not done before birth."
April said: "Thinking that everything was perfect then finding out that you have something so rare one in 30,000 and that the chance of survival was 50 per cent - it just crushed us."
April, her husband Jason and their daughter Ellianna, now four, moved from Wisconsin to New Jersey so they could be near specialist surgeons who would carry out the surgery.
At 25 weeks Elijah was partially removed from April's womb, so that the tumour could be surgically removed from his left lung.
Halfway through the operation, Elijah's heart stopped, but the doctors massaged it until it started beating again, and put Elijah back inside his mother's womb.
During the surgery they inadvertently pierced Elijah's diaphragm, leaving him with a hernia which four weeks later caused his chest to rupture and lung to collapse.
Elijah was born seven weeks prematurely on November 19, 2012, and he was immediately rushed into intensive care.
He underwent two more surgeries before the family were able to return home nine weeks later.
For the first year of his life Elijah had to be fed through a tube that pumped food directly into his stomach.
Although the tube has now been removed, and therapy has taught him to chew and swallow, Elijah doesn't have much of an appetite, so to make up for it, his mum feeds him high-calorie food like avocados and peanut butter, and adds whipping cream to his milk.
In the long term Elijah is not expected to suffer any lasting ill effects from his difficult early years, but his mum reckons he has developed a more cautious disposition than other children his age.
"He walks through life making sure he is going to be OK," said April.