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Zhu Y, Xu L, Beejadhursing R, Chen S. External fetus in fetu presenting in the second trimester: A case report and literature review. Clin Case Rep 2023; 11:e8057. [PMID: 38028032 PMCID: PMC10675099 DOI: 10.1002/ccr3.8057] [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: 08/01/2023] [Revised: 09/28/2023] [Accepted: 10/03/2023] [Indexed: 12/01/2023] Open
Abstract
Fetus in fetu (FIF) is a rare congenital anomaly that originates from various sites of the host twin's body. The clinical manifestations of FIF are diverse and the location and size of FIF indicate the degree of threat, which may directly affect the prognosis. A 33-year-old woman presented at the hospital with an abdominal mass in her fetus. Prenatal ultrasound observed that mass included soft tissue, bone-like structures, and fluid. Immature cartilage, nerve tissue, muscle tissue, and glands in the parasitic fetus without signs of neoplastic lesions were reported by histological examination. CNV (copy number variation) and WES (whole exome sequencing) did not detect any abnormal mutations. FIF can continue to grow with gestational age or host infant growth. So complete resection is essential for improving the outcome of the host twin. It is also important that long-term follow-up is recommended to monitor any residual or recurrent cysts or malignancies.
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Affiliation(s)
- Ying Zhu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Le Xu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Rajluxmee Beejadhursing
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Suhua Chen
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
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Muacevic A, Adler JR, Mendieta LR. The First Case of Fetus in Fetu in Nicaragua: The Management Experience of the Pediatric Neurosurgery Team. Cureus 2023; 15:e33835. [PMID: 36819441 PMCID: PMC9931383 DOI: 10.7759/cureus.33835] [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: 01/15/2023] [Indexed: 01/18/2023] Open
Abstract
Fetus in fetu (FIF) is a rare congenital anomaly of asymmetric monozygotic twins, where the parasitic twin develops abnormally inside the body of the host twin. In most cases, it is incorporated into the sibling's abdomen, which frequently presents as a retroperitoneal mass. Currently, at least 200 cases have been reported worldwide, being this the first case in Nicaragua. We describe a case of a male newborn, born via cesarean section, with a history of multiple congenital malformations observed via ultrasound examination. At birth, a mass is observed on its dorsum that impresses a skull, but without the presence of bones, with three limbs, two upper and one lower, with an outline located transversely on the pelvic girdle and the presence of two male genitalia with agenesis of the testicles and an accessory kidney. A preoperative diagnosis of FIF and spinal dysraphism was made by computed tomography (CT) and magnetic resonance imaging (MRI). They shared a spinal cord and had the presence of an open spinal defect type meningocele with aberrant roots. After the diagnosis and discussion, the multidisciplinary team proceeded to surgery to perform the separation of the twin (FIF). The subsequent anatomopathological examination revealed that the fetus was anencephalic and had reliable FIF characteristics. The resection was performed followed by the closure of the 430 mL meningocele and complete separation of the spine and the parasitic twin. We present the first case of fetus in fetu in Nicaragua.
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Zhi X, Hu B, Zhao X, Chen J, Gu C, Pu L, Fang Y, Cai C. A cohort of five cases with asymmetric conjoined twining and literature review. Pediatr Surg Int 2022; 38:169-181. [PMID: 34467432 DOI: 10.1007/s00383-021-05006-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/26/2021] [Indexed: 02/01/2023]
Abstract
PURPOSE Asymmetric conjoined twining (ACT) is a form of conjoined twining which is a rare malformation of monochorionic monoamniotic twin pregnancy. Most publications were single case reports. We reported a cohort of five cases with ACT from a single tertiary medical center and reviewed the case reports of ACT over the last decade to enrich the clinical research of this disease and summarized the clinical features of the disease. METHODS We reviewed five cases of ACT admitted in Tianjin Children's Hospital from 17 March, 2008, through 7 March 2017. The cohort was analysed from general information, imaging manifestations, separation surgery, histopathological findings, outcome and follow-up. We searched the English literatures on case reports of ACT over the past decade from the PubMed database and presented details about the clinical characteristics, treatment, and prognosis of all cases. RESULTS There were four males and one female in our cohort. Among the five cases, two parasites were located in epigastrium, two in rachis, and one in retroperitoneum (fetus in fetu, FIF). All of the parasites were separated successfully by operation in five cases and were confirmed to be ACT by histopathology reports. Four patients made an uneventful recovery except for one case of wound infection. All of them were doing well in follow-up. In the literature review, we found 41 cases of exoparasitic heteropagus twining (EHT) and 63 cases of FIF. CONCLUSIONS ACT is very rare and usually diagnosed by prenatal ultrasonography (US). Computed tomography (CT) and magnetic resonance imaging (MRI) examinations are essential imaging examinations before separation surgery to delineate the anatomical relationship between the autosite and the parasite. In general, the separation surgery of ACT is less complicated and the prognosis is better compared with the symmetric conjoined twining (SCT).
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Affiliation(s)
- Xiufang Zhi
- Graduate College of Tianjin Medical University, Tianjin, 300070, China.,Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, 300134, China
| | - Bo Hu
- Department of Neonatal Surgery, Tianjin Children's Hospital, Tianjin, 300134, China
| | - Xuwen Zhao
- Department of Neonatal Surgery, Tianjin Children's Hospital, Tianjin, 300134, China
| | - Jing Chen
- Department of Radiology, Tianjin Children's Hospital, Tianjin, 300134, China
| | - Chunyu Gu
- Graduate College of Tianjin Medical University, Tianjin, 300070, China.,Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, 300134, China
| | - Linjie Pu
- Graduate College of Tianjin Medical University, Tianjin, 300070, China.,Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, 300134, China
| | - Yulian Fang
- Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, 300134, China.,Tianjin Pediatric Research Institute, Tianjin, 300134, China.,Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin, 300134, China
| | - Chunquan Cai
- Tianjin Children's Hospital (Children's Hospital of Tianjin University), Tianjin, 300134, China. .,Tianjin Pediatric Research Institute, Tianjin, 300134, China. .,Tianjin Key Laboratory of Birth Defects for Prevention and Treatment, Tianjin, 300134, China. .,Department of Neurosurgery, Tianjin Children's Hospital, No. 238 Longyan Road, Beichen District, Tianjin, 300134, China.
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