180417-N-UP035-0049 PUERTO BARRIOS, Guatemala (April

180417-N-UP035-0049 PUERTO BARRIOS, Guatemala (April 17, 2018) Axel Medina Roca sits on the operating table before U.S. Navy and Guatemalan doctors remove a plexiform neurofibroma from his face at the Hospital de Puerto Barrios in Puerto Barrios, Guatemala during Continuing Promise 2018. U.S. Naval Forces Southern Command/U.S. 4th Fleet has deployed a force to execute Continuing Promise to conduct civil-military operations including humanitarian assistance, training engagements, and medical, dental, and veterinary support in an effort to show U.S. support and commitment to Central and South America. (U.S. Navy photo by Mass Communication Specialist 1st Class Mike DiMestico / Released)