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M SC, Peethambar BA. Fetus in Fetu: A Rare Congenital Anomaly Diagnosed Postnatally by Ultrasonography and MRI. Cureus 2023; 15:e41550. [PMID: 37554598 PMCID: PMC10405024 DOI: 10.7759/cureus.41550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2023] [Indexed: 08/10/2023] Open
Abstract
Fetus in fetu (FIF) is a rare congenital anomaly with two controversial theories regarding its embryogenesis. Although it is an extremely rare condition, it should be kept in mind as a differential diagnosis while evaluating children with abdominal calcification. Radiological findings on postnatal days 2 and 5 of a neonate with an antenatal scan showing an abdominal mass in the fetus are described here. Ultrasonography and magnetic resonance imaging (MRI) revealed the mass in which the contents favored a diagnosis of the FIF. Characteristic features of FIF on MRI have been less explored and knowledge regarding the same will be of immense help to the radiologist. Complete surgical excision followed by histopathology confirmed the diagnosis.
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Affiliation(s)
- Sandra C M
- Diagnostic Radiology, Muslim Educational Society (MES) Medical College, Perinthalmanna, IND
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2
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Yang Z, Du L, Zhang H. Congenital orbital teratoma: A clinicopathologic case report. J Obstet Gynaecol Res 2021; 47:2225-2229. [PMID: 33719103 DOI: 10.1111/jog.14744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/30/2021] [Accepted: 02/28/2021] [Indexed: 11/30/2022]
Abstract
Here we report an extremely rare case of immature congenital orbital teratoma. The ultrasound scan at the 28+1 week of gestation revealed a massive, solid, and cystic mass in the left orbital region of the fetus. The lesion site was confirmed by magnetic resonance imaging. Based on clinical examination and imaging, the diagnosis of orbital teratoma without intracranial extension was made. Histopathological examination further confirmed the diagnosis of immature teratoma. The clinical course, radiographic, and histopathological findings of this disease were also summarized.
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Affiliation(s)
- Zhifen Yang
- Department of Obstetrics and Gynecology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lijia Du
- Department of Obstetrics and Gynecology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Huixin Zhang
- Department of Obstetrics and Gynecology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
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3
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Surgical resection of antenatally diagnosed orbital teratoma resulting in preservation of the globe. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2020. [DOI: 10.1016/j.epsc.2020.101565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Wang L, Long B, Zhou Q, Zeng S. Prenatal diagnosis of a "living" oropharyngeal fetus in fetu: a case report. BMC Pregnancy Childbirth 2019; 19:453. [PMID: 31783734 PMCID: PMC6884814 DOI: 10.1186/s12884-019-2612-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 11/19/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUD Fetus in fetu (FIF) is a rare malformation in which a parasitic twin within its more mature twin. Most of the FIF locate in the retroperitoneum and are acardiac and anencephalic. CASE PRESENTATION Here, we describe a unique case of oropharyngeal fetus in fetu with a rudimentary two-chambered heart detected by prenatal ultrasonography. The parents terminated this pregnancy after counseling. Macroscopic examination found a solid mass between the oral and fetal chest, with a rudimentary two-chambered heart at the lowest part of the mass. Microscopic findings showed amniotic membrane, skin, cartilage, gastrointestinal and neural tissue. CONCLUSIONS Prenatal ultrasound can identify rudimentary organs suspecting FIF from early pregnancy. Detection of fetal heart beat facilitates differential diagnosis with teratomas, providing essential information for parental consulting and management.
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Affiliation(s)
- Ling Wang
- Department of Ultrasound Diagnosis, Maternal and Child Health Center of Zhuzhou, 128 Station Road, Zhuzhou, Hunan, China
| | - Baiguo Long
- Department of Ultrasound Diagnosis, Maternal and Child Health Center of Zhuzhou, 128 Station Road, Zhuzhou, Hunan, China
| | - Qichang Zhou
- Department of Ultrasound Diagnosis, The Second Xiangya Hospital of Central South University, 139 Renmin Road (M), Changsha, 410011, Hunan, China
| | - Shi Zeng
- Department of Ultrasound Diagnosis, The Second Xiangya Hospital of Central South University, 139 Renmin Road (M), Changsha, 410011, Hunan, China.
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Proboscis lateralis: A case report of a rare giant craniofacial teratoma in an infant. Arch Plast Surg 2018; 45:578-582. [PMID: 30466239 PMCID: PMC6258982 DOI: 10.5999/aps.2017.01739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 06/07/2018] [Indexed: 11/15/2022] Open
Abstract
Teratomas can occur in almost any region of the body and are the most common extragonadal germ cell childhood tumors. However, craniofacial teratomas are rare. Craniofacial teratomas can present unique features and cause significant functional and aesthetic concerns. There are complex lesions that can have components intra-cranially and extra-cranially. Therefore, their management requires significant multi-stage multidisciplinary surgical procedures. Herein, we present a case of craniofacial teratoma in a child with the phenotype of proboscis lateralis that highlights some of the pertinent point of the diagnosis and management of congenital neonatal teratomas.
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Ruffo G, Di Meglio L, Di Meglio L, Sica C, Resta A, Cicatiello R. Fetus-in-fetu: two case reports. J Matern Fetal Neonatal Med 2018; 32:2812-2819. [PMID: 29804477 DOI: 10.1080/14767058.2018.1449207] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The objective of our study is to describe the sonographic findings of an extremely rare pathology. We therefore present two case reports of prenatal diagnosis of fetus-in-fetu (FIF) with a review of the literature. FIF is a benign disorder, unlike the teratoma with which often enter into the differential diagnosis, localized in most cases in the retroperitoneal space. Prenatal diagnosis is based mainly on ultrasound and radiological characteristics. The treatment of choice is surgical excision. The importance of prenatal diagnosis of fetus-in-fetu and the effect on subsequent management are described.
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Affiliation(s)
- Gabriele Ruffo
- a Diagnostica Ecografica e Prenatale "Aniello Di Meglio" , Napoli , Italia
| | - Lavinia Di Meglio
- a Diagnostica Ecografica e Prenatale "Aniello Di Meglio" , Napoli , Italia
| | - Letizia Di Meglio
- a Diagnostica Ecografica e Prenatale "Aniello Di Meglio" , Napoli , Italia
| | - Carmine Sica
- a Diagnostica Ecografica e Prenatale "Aniello Di Meglio" , Napoli , Italia
| | - Alessandro Resta
- a Diagnostica Ecografica e Prenatale "Aniello Di Meglio" , Napoli , Italia
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Yu YR, Espinoza J, Mehta DK, Keswani SG, Lee TC. Perinatal diagnosis and management of oropharyngeal fetus in fetu: A case report. JOURNAL OF CLINICAL ULTRASOUND : JCU 2018; 46:286-291. [PMID: 28949025 DOI: 10.1002/jcu.22528] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 04/24/2017] [Accepted: 07/17/2017] [Indexed: 06/07/2023]
Abstract
Fetus in fetu is an extremely rare congenital anomaly. We describe the perinatal diagnosis and management of a fetus with oropharyngeal and cervical fetus in fetu. High-resolution ultrasonography with 3-dimensional rendering can identify increased risks of airway obstruction in utero. Early identification allows a multidisciplinary team to be assembled for a scheduled ex utero intrapartum treatment procedure.
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Affiliation(s)
- Yangyang R Yu
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital, Baylor College of Medicine, 6701 Fannin Street, Suite 1210, Houston, Texas 77030
| | - Jimmy Espinoza
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine, Texas Children's Hospital, Baylor College of Medicine, 6651 Main Street, Suite F420, Houston, Texas 77030
| | - Deepak K Mehta
- Division of Otolaryngology, Texas Children's Hospital, Baylor College of Medicine, 6701 Fannin Street, Suite 540, Houston, Texas 77030
| | - Sundeep G Keswani
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital, Baylor College of Medicine, 6701 Fannin Street, Suite 1210, Houston, Texas 77030
| | - Timothy C Lee
- Division of Pediatric Surgery, Michael E. DeBakey Department of Surgery, Texas Children's Hospital, Baylor College of Medicine, 6701 Fannin Street, Suite 1210, Houston, Texas 77030
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Abstract
A 3.5-month-old boy was hospitalized because of an abdominal mass found accidentally. On physical examination, a smooth, firm, nontender mass was present in the right upper quadrant. Abdominal ultrasonography revealed a large, hyperechoic, heterogenous mass with clear boundaries, and scarce blood flow. Abdominal CT scan showed a bulky right retroperitoneal mass. Three-dimensional CT imaging demonstrated spine, iliac bone, and long bones of limbs. The mass was excised successfully. After opening the sac it was noted to contain an incompletely developed fetus with grossly visible limbs, clearly discernible male genitalia, hairs, and a poorly formed head. The fetus was connected to the sac via an 8 cm cord-like structure. Microscopic examination of the mass revealed the presence of skin, cartilage, bone, intestine, and cysts with simple cuboidal epithelium. The use of CT scans enhanced the accuracy of pre-operative diagnosis. Identification of the vertebral column and the long bones of limbs are important indications for the diagnosis. Pathologically, fetus in fetu has many characteristics different from teratoma.
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Calda P, Novotná M, Cutka D, Břešt'ák M, Hašlík L, Goldová B, Vítková I, Vaněčková M, Seidl Z. A case of an epignathus with intracranial extension appearing as a persistently open mouth at 16 weeks and subsequently diagnosed at 20 weeks of gestation. JOURNAL OF CLINICAL ULTRASOUND : JCU 2011; 39:164-168. [PMID: 21387329 DOI: 10.1002/jcu.20762] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Accepted: 09/20/2010] [Indexed: 05/30/2023]
Abstract
We report a rare case of oral mass (epignathus) with intracranial extension originally suspected antenatally at 16 weeks' gestation because of a persistent open mouth. Postmortem MRI and pathologic examination of the fetus confirmed an oral teratoma with bilateral ventricular dilatation, corpus callosum agenesis, and a neuroepithelial intracranial cyst. The relevant literature regarding this anomaly is reviewed.
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Affiliation(s)
- Pavel Calda
- Charles University in Prague, First Faculty of Medicine, Department of Obstetrics and Gynecology of the First Faculty of Medicine and General University Hospital, Apolinářská 18, 128 51, Prague 2, Czech Republic
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Affiliation(s)
- T E Herman
- Mallinckrodt Institute of Radiology, St Louis Children's Hospital, Washington University School of Medicine, St Louis, MO 63110, USA
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Braimoh KT, Abdulkadir AY, Balogun RO. Orocervical foetus-in-foetu with prenatal sonographic diagnosis: a case report. J Med Case Rep 2008; 2:362. [PMID: 19055795 PMCID: PMC2612683 DOI: 10.1186/1752-1947-2-362] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2008] [Accepted: 12/04/2008] [Indexed: 11/10/2022] Open
Abstract
Introduction Foetus-in-foetu is a very rare congenital abnormality where a malformed foetus is included within the body of another foetus. Less than 200 cases have been reported with over 80% occurring in the abdomen. Only three cases of cervical foetus in foetu have been reported. The present case of giant orocervical foetus-in-foetu appears to be an index case. Case presentation This is a report of an extremely rare orocervical foetus-in-foetu with grotesque oddity diagnosed on prenatal ultrasonography at 35 weeks gestational age in a 28-year-old, G2P1+0, Nigerian woman who was unsure of her last menstrual date or month. The included foetus had two eyes, cranium, nose, long bones and a spine. The mother's attempts at vaginal delivery rather than the elective Caesarean delivery she was offered resulted in obstructed labour and intrauterine foetal demise. Conclusion Giant cervical foetus-in-foetu is extremely rare. It could result in obstructed labour if vaginal delivery is attempted.
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Affiliation(s)
- Kolawole T Braimoh
- Department of Radiology, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria.
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Aslanabadi S, Spinner RJ, Zarrintan S, Ghasemi B, Jabbari-Moghaddam Y, Khaki AA, Sadat ATE. A neonate with cleft palate and a fetal mass in the oral cavity: a rare case of an oral fetus-in-fetu. Int J Pediatr Otorhinolaryngol 2007; 71:1617-22. [PMID: 17628706 DOI: 10.1016/j.ijporl.2007.05.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2007] [Revised: 05/23/2007] [Accepted: 05/27/2007] [Indexed: 10/23/2022]
Abstract
Fetus-in-fetu is a rare congenital condition in which a malformed fetus-like structure is found in the body of its twin. We report a unique case of a male neonate with cleft palate and a fetus-like structure arising in his oral cavity. The neonate underwent emergent surgical removal of the mass immediately after delivery. Radiological and pathological studies of the resected mass provided supportive evidence for the case of an oral fetus-in-fetu. To our knowledge, there are few cases of oral fetus-in-fetu in the literature. Moreover, the presence of cleft palate in this neonate is of potential interest and clinical importance.
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Affiliation(s)
- Saeid Aslanabadi
- Division of Pediatric Surgery, Children's Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
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Zarrintan S, Aslanabadi S. Comment on "The Ex Utero Intrapartum Treatment (EXIT) procedure used for airway control in a newborn with cervical fetus-in-fetu: a rare case" by Woodard et al. [Int. J. Pediatr. Otorhinolaryngol. 70 (2006) 1989-1994]. Int J Pediatr Otorhinolaryngol 2007; 71:1491-2; author reply 1493. [PMID: 17614144 DOI: 10.1016/j.ijporl.2007.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2007] [Accepted: 05/27/2007] [Indexed: 11/29/2022]
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Tofigh AM, Kavyani A, Abdollahi SM, Kazemzadeh G, Salman DN. Fetus in fetu: report of a case and literature review. Int J Surg 2007; 6:e94-6. [PMID: 17604707 DOI: 10.1016/j.ijsu.2007.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2007] [Revised: 04/18/2007] [Accepted: 04/23/2007] [Indexed: 10/23/2022]
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Zhang GZ, Din GC, Zhao YF. Giant Epignathus Teratoma: Report of a Case. J Oral Maxillofac Surg 2007; 65:337-40. [PMID: 17236946 DOI: 10.1016/j.joms.2005.05.323] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2005] [Accepted: 05/10/2005] [Indexed: 11/24/2022]
Affiliation(s)
- Guo Zhi Zhang
- Department of Oral and Maxillofacial Surgery, Shenzhen People's Hospital, Medical School of Jinan University, Shenzhen, GD, PR China.
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Woodard TD, Yong S, Hotaling AJ. The Ex Utero Intrapartum Treatment (EXIT) procedure used for airway control in a newborn with cervical fetus in fetu: a rare case. Int J Pediatr Otorhinolaryngol 2006; 70:1989-94. [PMID: 16938354 DOI: 10.1016/j.ijporl.2006.06.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2006] [Accepted: 06/27/2006] [Indexed: 11/24/2022]
Abstract
Fetus in fetu is a condition in which there is a monozygotic diamniotic fetus encased within the body of its larger more developed twin. We report a case of airway obstruction in a full-term fetus caused by fetus in fetu. Prenatal ultrasound revealed a large cervical mass compressing the neonate's trachea and esophagus. The Ex Utero Intrapartum Treatment procedure was utilized to secure the fetus's airway. Upon resection, a fetiform structure, covered by skin with vertebral tissue and two appendages was appreciated. To our knowledge, this is the first reported case of cervical fetus in fetu in the literature.
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Affiliation(s)
- Troy D Woodard
- Department of Otolaryngology Head & Neck Surgery, Loyola University Medical Center, IL 60153, United States
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Borges E, Lim-Dunham JE, Vade A. Fetus in fetu appearing as a prenatal neck mass. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2005; 24:1313-6. [PMID: 16123193 DOI: 10.7863/jum.2005.24.9.1313] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Elizabeth Borges
- Loyola University Chicago Stritch School of Medicine, Maywood, IL 60153, USA
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Aoki K, Matsumoto Y, Hamazaki M, Sano M, Fukumoto K, Fukaya T, Kuroda K, Tsutsumi R. MRI reveals fetus in fetu in the mediastinum. Pediatr Radiol 2004; 34:1017-9. [PMID: 15490152 DOI: 10.1007/s00247-004-1295-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2004] [Revised: 07/02/2004] [Accepted: 07/02/2004] [Indexed: 11/24/2022]
Abstract
Fetus in fetu is an extremely rare condition in which a fetiform calcified mass is contained within the newborn or infant, often in the retroperitoneal cavity. We report a case of a fetus in fetu in the posterior mediastinum of a newborn. The prospective diagnosis was made by fetal US and MRI and confirmed by postnatal plain radiograph, CT and MRI.
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Affiliation(s)
- Katsuhiko Aoki
- Department of Radiology, Shizuoka Children's Hospital, 422-8660 Shizuoka, Japan.
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Current awareness in prenatal diagnosis. Prenat Diagn 2004. [DOI: 10.1002/pd.782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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