1
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Uy MNAR, Tantengco OAG. Investigating the landscape and trajectory of spina bifida research in Asia: a bibliometric analysis. Childs Nerv Syst 2022; 38:1581-1591. [PMID: 35474541 DOI: 10.1007/s00381-022-05527-2] [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] [Received: 02/23/2022] [Accepted: 04/10/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Spina bifida is a type of a neural tube defect which affects 243.14 per 100,000 babies in Asia. Research articles on spina bifida have increased in the recent years. However, no study has focused on the research trends in this field in Asia. METHODS A systematic review of literature on spina bifida in Asia was performed using the Scopus database from inception to 2020. All published studies on spina bifida conducted in or published by authors from Asia were included in our analysis. Bibliometric information was obtained from Scopus and bibliometrics diagrams were created using VOSviewer software. RESULTS A total of 652 articles were obtained in this study. The number of publications showed an upward trend starting 2000s. The country with the greatest number of publications was Japan while All India Institute of Medical Sciences was the most productive institution in spina bifida research in Asia. The current focus of this field in Asia was prevalence of spina bifida, prenatal diagnosis, folic acid supplementation, and complications of spina bifida. Future areas of research in spina bifida include the genetic basis of neural tube defects and the use of stem cell technology as therapies for spina bifida. CONCLUSION This is the first bibliometric analysis on spina bifida in Asia. It showed the trend and future areas of research on spina bifida in Asia. Despite the increase in scientific literature on spina bifida research, more research outputs and collaborations are needed especially in developing countries in Asia.
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Affiliation(s)
| | - Ourlad Alzeus G Tantengco
- College of Medicine, University of the Philippines Manila, Pedro Gil Street, Ermita, Manila, Philippines.
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2
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Fully developed accessory lower limb with tethered cord: Are these two anomalies related? Childs Nerv Syst 2021; 37:325-328. [PMID: 32328705 DOI: 10.1007/s00381-020-04616-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 04/07/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Spinal dysraphic anomalies may be hidden beneath grotesque cutaneous stigmata, like a fully developed accessory lower limb. CASE DESCRIPTION Authors describe a 4-year-old boy who had socially unacceptable malformation in form of an accessory lower limb, in addition to perfectly normal both lower limbs with underlying low-lying tethered cord. Radiological studies showed underlying tethered cord and dysraphic spinal column. CONCLUSION Successful surgical correction was undertaken along with detethering of cord. The present case asks for evaluation of all cutaneous stigmata over spinal regions in newborns for spinal dysraphic states.
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3
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Saaiq M, Zimri FK, Zaman KU. Successful Treatment of Well-Developed Accessory Lower Limb Associated with Spinal Dysraphism. World J Plast Surg 2020; 9:73-81. [PMID: 32190596 PMCID: PMC7068195 DOI: 10.29252/wjps.9.1.73] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Accessory lower limb with spinal dysraphism are amongst the rarest known anomalies. We successfully managed a 5-months old female infant with surgical ablation of the accessory lower limb and repair of the associated large lipomyelomeningocele. A comprehensive review of the relevant literature was undertaken and presented herein. A classification system for accessory lower limb is also proposed.
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Affiliation(s)
- Muhammad Saaiq
- Department of Plastic Surgery, National Institute of Rehabilitation Medicine (NIRM), Islamabad, Pakistan
| | - Faridullah Khan Zimri
- Department of Orthopedic Surgery, National Institute of Rehabilitation Medicine (NIRM), Islamabad, Pakistan
| | - Khaleeq-Uz Zaman
- Department of Neurosurgery, National Institute of Rehabilitation Medicine (NIRM), Islamabad, Pakistan
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4
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Khavanin N, Ruge JR, Vicari FA, Belin EJ, Kellogg RG, Steinberg JP. Parasitic rachipagus conjoined twin: case report. J Neurosurg Pediatr 2018; 22:313-316. [PMID: 29882735 DOI: 10.3171/2018.3.peds1822] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A parasitic twin represents a rare developmental anomaly in which an asymmetrical, nonviable conjoined twin is attached to the host body at the time of birth. Rachipagus is among the rarest of conjoined twin subtypes and typically features a parasitic twin mass attached at the spine. Herein, the authors review the literature and describe the case of a 9-month-old girl presenting with a rachipagus parasitic twin consisting of a fully developed set of lower extremities originating from the midline upper back. After a complete workup to delineate parasite and autosite anatomy, the parasitic twin mass was successfully excised by a multidisciplinary team of surgeons, and the resulting defect was closed in a single stage.
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Affiliation(s)
- Nima Khavanin
- 1Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland; and
| | | | | | - Eric J Belin
- 4Pediatric Orthopedic Surgery, Advocate Children's Hospital, Park Ridge, Illinois
| | | | - Jordan P Steinberg
- 1Department of Plastic and Reconstructive Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland; and
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5
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Kelani AB, Moumouni H, Issa AW, Younsaa H, Fokou H, Sani R, Sanoussi S, Denholm LJ, Beever JE, Catala M. Notomelia and related neural tube defects in a baby born in Niger: case report and literature review. Childs Nerv Syst 2017; 33:529-534. [PMID: 28083641 DOI: 10.1007/s00381-017-3337-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 01/03/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Notomelia associated with neural tube defects are rare diseases. CASE REPORT A baby was born in Niger with multiple congenital embryonic malformations on the posterior midline. The most rostral malformation was an accessory limb (polymelia) at the level of the lumbar vertebrae composed of two long bones, a foot and three toes. Accessory male genitalia were present at the base of this malformed accessory limb which had no apparent motor or sensory innervation. The second malformation was a sacral vestigial appendage with an adjacent dermal sinus opening onto the posterior midline and extending internally to the dura through a defect of the vertebral arches. From the published literature and this particular case, we conclude that notomelia is a rare clinical sequela of a neural tube defect (NTD) and is correctly classified as a dysraphic appendage. CONCLUSION The recent occurrence of three similar cases in the same ethnic group from Niger, three from consanguineous parents, suggests that genetic factors are likely to contribute significantly to the genesis of this syndrome, consistent with a recent report that mutation of the bovine NHLRC2 gene resulting in a V311A substitution at a highly conserved locus in the NHLRC2 protein is, when homozygous, causally associated with several forms of polymelia including notomelia, with heteropagus conjoined twinning and with other NTD-related embryonic malformations. Detailed genome-wide studies of children with dysraphic appendages are indicated.
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Affiliation(s)
- A B Kelani
- Département de Chirurgie, Faculté des Sciences de la Santé (FSS), Université Abdou Moumouni (UAM), Niamey, Niger
- Service de Neurochirurgie, Hôpital National, Niamey, Niger
| | - H Moumouni
- Département d'Embryologie, FSS, UAM, Niamey, Niger
| | - A W Issa
- Service de Neurochirurgie, Hôpital National, Niamey, Niger
| | - H Younsaa
- Service de Chirurgie Générale, Hôpital National, Niamey, Niger
| | - Hmu Fokou
- Service de Chirurgie Générale, Hôpital National, Niamey, Niger
| | - R Sani
- Service de Chirurgie Générale, Hôpital National, Niamey, Niger
| | - S Sanoussi
- Département de Chirurgie, Faculté des Sciences de la Santé (FSS), Université Abdou Moumouni (UAM), Niamey, Niger
- Service de Neurochirurgie, Hôpital National, Niamey, Niger
| | - L J Denholm
- NSW Department of Industry, Orange NSW, Australia
| | - J E Beever
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - M Catala
- Sorbonne Université, UPMC Université Paris 06, UMR7622, F-75005, Paris, France.
- CNRS, Institut de Biologie Paris Seine (IBPS) - Developmental Biology Laboratory, UMR7622, F-75005, Paris, France.
- INSERM, ERL1156, F-75005, Paris, France.
- Fédération de Neurologie, Groupe hospitalier Pitié-Salpêtrière-APHP, F-75013, 47-83 Bd de l'Hôpital, 75651, Paris Cedex 13, France.
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6
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Proposed caudal appendage classification system; spinal cord tethering associated with sacrococcygeal eversion. Childs Nerv Syst 2017; 33:69-89. [PMID: 27497702 DOI: 10.1007/s00381-016-3208-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 07/26/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The most commonly used classification system for caudal appendages (aka human tails) dates from the 1980s and classifies appendages (tails) as either true tails or pseudotails. Advances in neuroimaging since the 1980s, however, as well as an ever-increasing number of reported cases, have made this system outdated. Sacrococcygeal eversion is a condition in which the distal sacral and coccygeal vertebrae are curved in a retroverted rather than anteverted direction. It can give rise to one type of caudal appendage. Sacrococcygeal eversion has never been associated with spinal cord tethering in any previously published reports. METHODS We reviewed all cases of caudal appendage encountered by pediatric neurosurgeons at Children's Hospital Colorado since 2000 in which the appendage would be classified as a true tail by the most commonly used system mentioned above. We also reviewed cases of sacrococcygeal eversion encountered since 2000 by the same group of pediatric neurosurgeons. We searched the hospital electronic medical record system for additional appendages using the terms "caudal appendage" and "persistent human tail." RESULTS We found 9 "true" tails (as classified by the most commonly used system). All 9 were associated with tethering or possible tethering of the spinal cord and 6 were associated with a low-lying conus medullaris. There were 8 cases of sacrococcygeal eversion, including 2 associated with Apert or Pfeiffer syndrome and fibroblast growth factor receptor 2 (FGFR2) mutations; these have previously been reported. There was a single case of sacrococcygeal eversion associated with Goldenhar or Turner syndrome; the former was associated with a potentially tethering lesion. Four cases of sacrococcygeal eversion not associated with any known syndrome were also found; two of these were associated with tethering or potentially tethering lesions. CONCLUSIONS Most so-called true tails are likely cutaneous markers for spinal dysraphism and spinal cord tethering and are not remnants of the embryonic human tail. Sacrococcygeal eversion can be associated with spinal cord tethering. Based on our cases, and on review of the literature, we devised a five-category classification system for caudal appendages: (1) soft-tissue caudal appendages, (2) bony caudal appendages, (3) bony caudal prominences, (4) true tails, and (5) "other" caudal appendages.
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7
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Kelani AB, Moumouni H, Younsa H, James Didier L, Hima AM, Guemou A, Issa AW, Ibrahim A, Sanda MA, Sani R, Sanoussi S, Catala M. A case of cephalomelia discovered in a baby born in Niger. Childs Nerv Syst 2016; 32:205-8. [PMID: 26227339 DOI: 10.1007/s00381-015-2831-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 07/09/2015] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Subcutaneous tumors with extra limbs are very rare, and they are considered either as fetus in fetu or fetiform teratoma. CASE REPORT We report here the case of a 6-day-old presenting a mass extending at the level of the occipital bone. This mass is developed in the extracranial region and contains two forelimbs including hands with digits. CT shows that the squamous part of the occipital bone is involved with several defects through which a part of the cerebellum herniates. The boy was operated on and the tumor was removed. The herniated region of the cerebellum has also been removed. After surgery, the boy develops normally. CONCLUSION This type of tumor is extremely rare and is only the second case that has been reported at this exact location. This could be the so-called céphalomélie described by Isidore Geoffroy Saint-Hilaire in a duck in his famous Treatise of Teratology (1836). The cause of this malformation is still a matter for debate.
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Affiliation(s)
- A Bariath Kelani
- Service de Neurochirurgie, Hôpital National de Niamey, Niamey, Niger. .,Faculté des Sciences de la Santé, Service de Neurochirurgie, Hôpital National de Niamey (HNN), Université Abdou Moumouni (UAM), BP 12932, Niamey, Niger.
| | - H Moumouni
- Faculté des Sciences de la Santé, Service de Neurochirurgie, Hôpital National de Niamey (HNN), Université Abdou Moumouni (UAM), BP 12932, Niamey, Niger.,Département d'Histologie et Embryologie, UAM, Niamey, Niger
| | - H Younsa
- Faculté des Sciences de la Santé, Service de Neurochirurgie, Hôpital National de Niamey (HNN), Université Abdou Moumouni (UAM), BP 12932, Niamey, Niger.,Service de Chirurgie Générale, Hôpital National de Niamey, Niamey, Niger
| | - L James Didier
- Faculté des Sciences de la Santé, Service de Neurochirurgie, Hôpital National de Niamey (HNN), Université Abdou Moumouni (UAM), BP 12932, Niamey, Niger.,Service de Chirurgie Générale, Hôpital National de Niamey, Niamey, Niger
| | - A M Hima
- Service de Neurochirurgie, Hôpital National de Niamey, Niamey, Niger
| | - A Guemou
- Service de Neurochirurgie, Hôpital National de Niamey, Niamey, Niger
| | - A W Issa
- Service de Neurochirurgie, Hôpital National de Niamey, Niamey, Niger
| | - A Ibrahim
- Service de Neurochirurgie, Hôpital National de Niamey, Niamey, Niger
| | - M A Sanda
- Service de Neurochirurgie, Hôpital National de Niamey, Niamey, Niger
| | - R Sani
- Faculté des Sciences de la Santé, Service de Neurochirurgie, Hôpital National de Niamey (HNN), Université Abdou Moumouni (UAM), BP 12932, Niamey, Niger.,Service de Chirurgie Générale, Hôpital National de Niamey, Niamey, Niger
| | - S Sanoussi
- Service de Neurochirurgie, Hôpital National de Niamey, Niamey, Niger.,Faculté des Sciences de la Santé, Service de Neurochirurgie, Hôpital National de Niamey (HNN), Université Abdou Moumouni (UAM), BP 12932, Niamey, Niger
| | - M Catala
- Sorbonne Université, UPMC Université Paris 06, UMR7622, F-75005, Paris, France.,Institut de Biologie Paris Seine (IBPS) - Developmental Biology Laboratory, UMR7622, CNRS, F-75005, Paris, France.,INSERM, ERL1156, F-75005, Paris, France.,Fédération de Neurologie, Groupe hospitalier Pitié-Salpêtrière-APHP, F-75013, Paris, France
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8
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Abstract
A patient with lipomyelomeningocele (known in utero) presented for MRI characterization prior to surgical procedure at three months of age. Cross-sectional imaging revealed a spinal dysraphism of the lower lumbar spine, with a posterior spinal defect spanning L4 to S2 subcutaneous fat intrusion, and distal spinal cord extrusion. An osseous excrescence was also appreciated, articulating with the left iliac bone. This case demonstrates the youngest known lipomyelomeningocele with accessory limb and the abnormal growth of multiple tissue types at the site of spinal dysraphism-a potential consequence of dedifferentiated cell proliferation originating from a secondary neural tube defect or rachipagus parasitic twinning.
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9
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Bayri Y, Tanrıkulu B, Ekşi MS, Dağçınar A. Accessory lower limb associated with spina bifida: case report. Childs Nerv Syst 2014; 30:2123-6. [PMID: 25092402 DOI: 10.1007/s00381-014-2475-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Accepted: 06/16/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Heterotopic redundancies, such as an accessory limb associated with spina bifida, are extremely rare anomalies. There are 12 cases of accessory limb associated with spinal bifida in literature. This report aims a detailed description of the additional case and an analysis of the findings in light. METHODS A male baby was born at 40 weeks of gestation and was referred to the neurosurgery clinic with a diagnosis of accessory lower limb. On physical examination, the dorsal meningocele was located at the lumbosacral region and there was accessory lower limb on it. There was no open neural placode. RESULTS The accessory limb was excised on postnatal day 3. CONCLUSIONS Dysraphic appendages are rare and complicated anomalies. They should be investigated carefully, and all of the lesions must be repaired for babies' quality of life.
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Affiliation(s)
- Yaşar Bayri
- Faculty of Medicine, Department of Neurosurgery, Marmara University, Marmara Üniversitesi Tıp Fakültesi, Selimiye M. Tıbbiye C. No:38, 34668, Haydarpaşa, Istanbul, Turkey,
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10
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Park KB, Kim YM, Park JY, Chung ML, Jung YJ, Nam SH. An accessory limb with an imperforate anus. Ann Surg Treat Res 2014; 87:213-6. [PMID: 25317418 PMCID: PMC4196430 DOI: 10.4174/astr.2014.87.4.213] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 01/14/2014] [Accepted: 01/14/2014] [Indexed: 11/30/2022] Open
Abstract
Congenital accessory limbs are very rare anomalies with many causative factors. We describe the case of a 1-day-old female neonate-born to a healthy, 27-year-old mother-who presented with an accessory limb (foot) attached to the buttock and an imperforate anus. We also provide a review of the relevant literature.
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Affiliation(s)
- Kun-Bo Park
- Department of Orthopaedic Surgery, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Yeon-Mee Kim
- Department of Pathology, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Ji-Yong Park
- Department of Orthopaedic Surgery, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Mi-Lim Chung
- Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Yu-Jin Jung
- Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, Korea
| | - So-Hyun Nam
- Department of Pediatric Surgery, Inje University Haeundae Paik Hospital, Busan, Korea
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11
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Chatterjee S, Mondal PC, Pandey SB, Achar A. Presence of accessory penis, colonic duplication and several other congenital anomalies in a child: a very rare association. Trop Doct 2014; 44:238-40. [PMID: 24705773 DOI: 10.1177/0049475514531130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
An accessory penis is a very rare anomaly. Only five cases have been reported thus far to our knowledge. We present the case of a child aged 2 years and 10 months who had a penis-like structure (containing phallus and glans) attached to the right buttock. Associated anomalies were a non-communicating type of colonic duplication, a paramedian stenosed anal opening, a horse-shoe kidney, posterior urethral valves, scoliosis of the lumbo-sacral spine, polydactyly and equino-varus deformity of the right foot. As far as we can tell, this is the first report of an accessory penis associated with colonic duplication and other congenital anomalies.
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Affiliation(s)
- Sayan Chatterjee
- Residential Medical Officer cum Clinical Tutor, Department of Paediatrics, Midnapore Medical College, Paschim Midnapore, India
| | - Prabodh Chandra Mondal
- Professor, Department of Pediatrics, Midnapore Medical College, Paschim Midnapore, India
| | - Shashi Bhushan Pandey
- Senior Consultant, Department of Radiology, Spandan Diagnostic Center, Paschim Midnapore, India
| | - Arun Achar
- Assistant Professor, Department of Dermatology, Midnapore Medical College, Paschim Midnapore, India
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12
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Abstract
At 7 months, an infant born with a third limb attached to a lumbosacral mass with an associated lipomyelomeningocele underwent removal of the limb and spinal cord detethering. Depending on the complexity of the pathology and proximity of the limb to viscera, consultation with neurosurgical and surgical colleagues is recommended.
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13
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A rare form of heteropagus twinning: three-armed infant with spinal dysraphism. Case Rep Pediatr 2013; 2012:831649. [PMID: 23304600 PMCID: PMC3530761 DOI: 10.1155/2012/831649] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2012] [Accepted: 11/26/2012] [Indexed: 11/18/2022] Open
Abstract
An ectopic or accessory limb attached to the back is an extremely rare and strange condition, and there are only a few documented cases in the worldwide literature. The first case was described by Jones and Larkin (1889). There are several theories regarding the origin of this condition. Asymmetric conjoined twinning which is located dorsally in the vertebral column (rachipagus) is the most probable diagnosis of our patient. Conjoined twinning is very rare and the incidence is 1 per 50 000 live births. Rachipagus is even rarer, with no more than 30 case reports so far (Chadha et al. (1993, 2006)). In this report, we present a patient who underwent successful surgical excision of a third arm attached to the back in the midline over the low-dorsal region. Differential diagnoses including teratoma and fetus in fetu are discussed.
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14
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Pandey A, Singh SP, Pandey J, Gupta V, Verma R. Lumbosacral parasitic twin associated with lipomeningomyelocele: a rare occurrence. Pediatr Neurosurg 2013; 49:110-2. [PMID: 24526054 DOI: 10.1159/000358096] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 12/18/2013] [Indexed: 02/05/2023]
Abstract
Lumbosacral parasitic twin is an extremely rare entity. About 200 cases have been reported in the literature. It may be associated with neural tube defects. We encountered a 3-day-old female child with this presentation, who was successfully operated on at the age of about 2 months. Being an uncommon entity, it is presented here.
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Affiliation(s)
- Anand Pandey
- Department of Surgery, UP Rural Institute of Medical Sciences and Research, Saifai, Etawah, India
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15
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Lee SH, Je BK, Kim SB, Kim BH. Adult with sacral lipomyelomeningocele covered by an anomalous bone articulated with iliac bone: computed tomography and magnetic resonance images. Congenit Anom (Kyoto) 2012; 52:115-8. [PMID: 22639999 DOI: 10.1111/j.1741-4520.2011.00335.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The present paper reports and discusses a case of sacral lipomyelomeningocele with an anomalous long bone articulating with the left iliac bone in a 40-year-old female. That patient had a monozygotic twin sister who had normal spine. The findings were incidental during an evaluation for a urinary tract infection. The computed tomography (CT) and magnetic resonance (MR) images revealed sacral dysraphism, lipomyelomeningocele, tethered spinal cord, and profound subcutaneous fat in the sacrococcygeal region. In addition, an anomalous bony strut was demonstrated on the posterior aspect of the sacrum, covering the sacral defect and the associated lipomyelomeningocele. The 3-D CT images of the anomalous bone associated with the sacral lipomyelomeningocele and the putative embryologic process are presented with a review of the literature.
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Affiliation(s)
- Seung Hwa Lee
- Department of Radiology, Korea University Ansan Hospital, Ansan, Republic of Korea
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16
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Wasnik AP, Shinagare A, Lalchandani UR, Gujrathi R, Pai BU. Rudimentary third lower limb in association with spinal dysraphism: Two cases. Indian J Orthop 2007; 41:72-5. [PMID: 21124687 PMCID: PMC2981900 DOI: 10.4103/0019-5413.30530] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Spinal dysraphism is a common congenital anomaly with many associated variants. One of the rarest associated findings is a full grown or rudimentary third limb, collectively called Tripagus. We present two cases of spinal dysraphism with rudimentary third limb arising from the ilium.
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Affiliation(s)
- Ashish P Wasnik
- Department of Radiology, Grant Medical College and Sir J.J Group of Hospital, Byculla, Mumbai - 400 008, India,Correspondence: Dr. Ashish P. Wasnik, C/o Mr. R. Lalchandani, 2, Neel Kamal Apts, O.T Section, Ulhasnagar - 421 001, India. E-mail:
| | - Atul Shinagare
- Department of Radiology, Grant Medical College and Sir J.J Group of Hospital, Byculla, Mumbai - 400 008, India
| | - Usha R Lalchandani
- Department of Radiology, Grant Medical College and Sir J.J Group of Hospital, Byculla, Mumbai - 400 008, India
| | - Rahul Gujrathi
- Department of Radiology, Grant Medical College and Sir J.J Group of Hospital, Byculla, Mumbai - 400 008, India
| | - Bhujang U Pai
- Department of Radiology, Grant Medical College and Sir J.J Group of Hospital, Byculla, Mumbai - 400 008, India
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17
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Abstract
A rare case of a newborn girl presenting with a mass representing an aborted parasitic twin attached to the back in the midline over the lumbosacral region (parasitic rachipagus) is reported. Rudimentary digits were attached to the mass, and in one area, the overlying skin resembled scrotal skin. A depression resembling an anal dimple was also present on the surface of the mass. Investigations showed a well-developed long bone and other small bones within the parasite, and sacral spina bifida in the autosite. Successful surgical excision of the parasitic mass was performed. A review of the literature pertaining to parasitic rachipagus twinning is presented.
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Affiliation(s)
- Rajiv Chadha
- Department of Pediatric Surgery, Lady Hardinge Medical College and associated Kalawati Saran and SK Hospitals, New Delhi 110001, India.
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Ilkehan H, Coban YK, Guven MA, Ceylaner S. Three new cases of disorganizationlike syndrome: one with accessory extrophia vesicalis. J Pediatr Surg 2004; 39:e6-8. [PMID: 15359417 DOI: 10.1016/j.jpedsurg.2004.05.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The authors report 3 unrelated Turkish cases of disorganizationlike syndrome. All of these patients have accessory limbs, and 2 of them have accessory genitourinary structures. Interestingly, one of these patients has extrophia vesicalis of accessory bladder. None of them have chromosomal abnormality. Here the authors present distribution of findings of these cases.
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Affiliation(s)
- Hasan Ilkehan
- Department of Pediatric Surgery, State Hospital, Kahramanmaras, Turkey
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Corona-Rivera JR, Corona-Rivera E, Franco-Topete R, Acosta-León J, Aguila-Dueñas V, Corona-Rivera A. Atypical parasitic ischiopagus conjoined twins. J Pediatr Surg 2003; 38:e3. [PMID: 12596123 DOI: 10.1053/jpsu.2003.50063] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Occurrence of asymmetrical or parasitic conjoined twins (CT) is rare, and currently they are classified analogically to the common unions of symmetrical CT. The authors report on an infant with a parasitic third limb attached to the left lateral aspect of the autosite trunk, in whom male gonadal tissue was found histologically. Parasite parts included complete left lower limb, hemipelvis, lumbosacral vertebral column, spinal cord, and one kidney with ureter and adrenal gland. Autosite anomalies comprised a small left diaphragmatic defect, omphalocele, exstrophy of cloaca, and lumbar meningomyelocele. The authors considered this case to be a rare atypical parasitic ischiopagus CT. The differential diagnosis of the type of twining and other entities with caudal duplications is analyzed briefly.
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Affiliation(s)
- J Román Corona-Rivera
- Laboratorio de Genética Humana y Clínica de Asesoramiento Genético, Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jal., México
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Ostad M, Mininberg DT, Harbison M, Magid MS. Thoracolumbar accessory penis: etiology, diagnosis, and management. Urology 1999; 53:425-7. [PMID: 9933072 DOI: 10.1016/s0090-4295(98)00353-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Human sacral appendages have rarely been reported. We present a neonate with a thoracolumbar appendage resembling a penis, and discuss the nature of the anomaly and its diagnosis and management.
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Affiliation(s)
- M Ostad
- Department of Urology, The James Buchanan Brady Foundation, New York, New York, USA
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Robin NH, Abbadi N, McCandless SE, Nadeau JH. Disorganization in mice and humans and its relation to sporadic birth defects. AMERICAN JOURNAL OF MEDICAL GENETICS 1997; 73:425-36. [PMID: 9415470 DOI: 10.1002/(sici)1096-8628(19971231)73:4<425::aid-ajmg11>3.0.co;2-t] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Disorganization (Ds) is a mouse mutant best known for producing an exceptional variety of unusual developmental anomalies, such as mirror-limb duplications and hamartomatous skin papillae. So great is the range of malformations that no two affected mice are identical. Several patients with a similar variety of exceptional anomalies have been reported, raising the possibility of the existence of a human homologue of Ds. However, although these human cases represent the most striking findings seen in Ds mice, they do not represent the full range of defects. Most affected mice have only a single malformation, and most of these malformations are similar to both common (neural tube defects, orofacial clefting, gastroschisis, limb reductions) and rare (anophthalmia, duplicated rectum) human birth defects. It is therefore possible that the full spectrum of the human homologue of Ds includes not only patients with the unusual combination of anomalies but also common sporadic birth defects. We suggest that the low penetrance (approximately 0-30%) and highly variable expression of Ds make it a paradigm for understanding the genetic basis for many seemingly sporadic birth defects.
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Affiliation(s)
- N H Robin
- Center for Human Genetics, Case Western Reserve University School of Medicine and University Hospitals of Cleveland, Ohio 44106-6506, USA
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Chitnavis JP, Lawson JO. Complete supernumerary leg in association with mesodermal abnormalities - a 16-year follow-up and literature review. Pediatr Surg Int 1996; 11:201-2. [PMID: 24057561 DOI: 10.1007/bf00183770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/12/1995] [Indexed: 10/26/2022]
Abstract
A male with a complete third leg in association with genito-urinary, anorectal, and colonic defects and an Arnold-Chiari malformation is described at birth and at 16 years of age following surgery. A short review of similar cases over the last century is presented and reference made to reported induction of similar abnormalities in vertebrates.
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Abstract
The authors report on a newborn with an accessory malformed leg attached to the back. The limb was associated with a teratomatous mass adjacent to its attachment site. The embryology and nomenclature of this malformation is discussed briefly.
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Affiliation(s)
- R Chadha
- Department of Pediatric Surgery, Lady Hardinge Medical College, New Delhi, India
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