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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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2
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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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3
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Fievet L, Serratrice N, Degardin N, Pech Gourg G, Lena G, Scavarda D. Multisurgical approach for recurrent fetus-in-fetu of the skull. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2018. [DOI: 10.1016/j.epsc.2017.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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4
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Fetus in fetu: an unusual case study for the neonatal nurse practitioner. Neonatal Netw 2012; 30:313-8. [PMID: 21846626 DOI: 10.1891/0730-0832.30.5.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Fetus in fetu is an extremely unusual occurrence where a rare congenital tumor containing a vertebral axis, often containing parts of other organs or limbs, is identified. Normally identified in the newborn period, the size and location of the mass may result in significant multiorgan compromise. This article presents the challenges encountered by the neonatal intensive care unit team in providing care for a late preterm female infant presenting with gross abdominal distension. Description of the case includes preoperative management along with management of severe coagulopathy and hemorrhage that arose during the intraoperative and postsurgical course of care. A brief overview of abdominal masses in the newborn is presented. The importance in determining the final diagnosis of fetus in fetu and its differentiation from teratoma is discussed.
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Chang TS, Shehata BM, Stallings C, Gow KW, Onyeije CI. Fetus in Fetu Presenting as an Abdominal Mass in a Newborn Female Infant. Am Surg 2008. [DOI: 10.1177/000313480807400929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Bahig M. Shehata
- Department of Pathology Children's Healthcare of Atlanta Atlanta, Georgia
| | - Carrie Stallings
- Department of Surgery Emory University School of Medicine Children's Healthcare of Atlanta Atlanta, Georgia
| | - Kenneth W. Gow
- Department of Surgery Emory University School of Medicine Children's Healthcare of Atlanta Atlanta, Georgia
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6
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Hui PW, Lam TPW, Chan KL, Lee CP. Fetus in fetu--from prenatal ultrasound and MRI diagnosis to postnatal confirmation. Prenat Diagn 2007; 27:657-61. [PMID: 17451188 DOI: 10.1002/pd.1733] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We report a case of fetus in fetu presented as a complex intra-abdominal heterogeneous cystic lesion during ultrasound examination of the fetus at 25 weeks of gestation. Progressive growth of this mass was noted in the prenatal period. Fetal magnetic resonance imaging provided additional information to aid in the prenatal diagnosis. This allows proper counselling for the parents and helps to plan the postnatal management. Surgical excision was carried out in the early neonatal period and the diagnosis of fetus in fetu was confirmed.
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Affiliation(s)
- Pui Wah Hui
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, China.
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7
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Abstract
Differentiation of abdominal masses detected on prenatal ultrasound is difficult and requires careful characterization of the mass and precise localization. Differentiation is required in order to distinguish benign from potentially malignant conditions. We describe a case of fetus-in-fetu with pre- and postnatal imaging.
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Affiliation(s)
- M K House
- Department of Radiology, The Mercy Hospital for Women, 163 Studley Road, Heidelberg, Victoria 3084, Australia
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8
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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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Beaudoin S, Gouizi G, Mezzine S, Wann AR, Barbet P. Mediastinal Fetus in fetu. Fetal Diagn Ther 2004; 19:453-5. [PMID: 15305103 DOI: 10.1159/000078999] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2003] [Accepted: 09/25/2003] [Indexed: 11/19/2022]
Abstract
Fetus in fetu is an extremely rare condition defined by the presence of both axial skeleton and organoid formations in the parasitic mass. Besides some authors assuming that fetus in fetu and highly-differentiated teratomas are part of the same pathogenic spectrum, it has been emphasized that these criteria indicate a rather different embryogenetic mechanism. We herein report the first case to our knowledge developed in the ventral mediastinum that was thought to be a tumor before birth. The literature is reviewed and we propose a new explanation for the development of this rare anomaly, based on a defective implantation.
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Affiliation(s)
- S Beaudoin
- Department of Pediatric Surgery, Groupe Hospitalier Cochin-Saint-Vincent de Paul, Paris, France.
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10
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Kapoor V, Flom L, Fitz CR. Oropharyngeal fetus in fetu. Pediatr Radiol 2004; 34:488-91. [PMID: 14740199 DOI: 10.1007/s00247-003-1103-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2003] [Revised: 09/05/2003] [Accepted: 10/22/2003] [Indexed: 10/26/2022]
Abstract
Fetus in fetu is an extremely rare entity and refers to the growth of a "parasitic" twin within a more mature fetus due to its inclusion within cells of the blastocyst. The presence of a vertebral column is considered essential for the diagnosis of a fetus in fetu. The retroperitoneum is the most common location for a fetus in fetu and its location in the mouth is rare. We report a case of oropharyngeal mass detected on antenatal sonography with imaging features consistent with a fetus in fetu. Complete surgical removal of the mass was aided by imaging. Follow-up of these patients is recommended to detect the rare incidence of malignant degeneration.
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Affiliation(s)
- Vibhu Kapoor
- Department of Radiology, Children's Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, PA 15213, USA.
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11
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Hall R, Johnson M. Long-Term Follow-up of Untreated Sacrococcygeal Teratoma Diagnosis in a Twin of Full-Term Gestation. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2002. [DOI: 10.1177/87579302018003005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Teratoma is a common congenital germ cell neoplasm. Sacrococcygeal teratoma is the most common type of teratoma and may be found incidentally during an obstetric ultrasound exam. Once discovered,serial exams are necessary to assess possible growth of the teratoma in relation to surrounding anatomy and to prepare for delivery management and postnatal surgery requirements.
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Affiliation(s)
- Rebecca Hall
- Department of Obstetrics-Gynecology, University of New Mexico Health Sciences Center,Albuquerque,NM 87131
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12
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Current Awareness. Prenat Diagn 2001. [DOI: 10.1002/pd.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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