Incomplete duplication of a lower extremity (polymelia): a case report

Presentation of polymelia in conjugation with spinal dysraphism: A case report

INTRODUCTION AND IMPORTANCE

Polymelia is a rare congenital deformity characterized by an extra limb connected to a different part of the body. The Incidence of this condition in humans is scant but relatively higher in animals. Hereditary and genetic factors are linked to the pathogenesis of this condition, but the relationship is not clearly understood. In this article, we highlight the presentation of polymelia and the approach used to treat the patient.

CASE PRESENTATION

A 3-month-old male was brought to medical attention by his parents, who expressed concern regarding an extra limb attached to his back. He was born via spontaneous vaginal delivery after an uncomplicated pregnancy, with the only significant finding being the additional limb. After a thorough evaluation by a multidisciplinary team, he was diagnosed with Polymelia associated with spinal dysraphism. The child underwent surgery to excise the extra limb and to seal the defect in the vertebrae.

CLINICAL DISSECTION

Polymelia is associated with multiple congenital malformations. Although it can be diagnosed in the antenatal period, most cases are identified after birth. The extra limb is usually functionless, but sensation may be preserved. It may be a well-developed limb or just a bud. A comprehensive evaluation is mandatory to explore the associated hidden malformation.

CONCLUSION

The expression of polymelia differs among individual case presentations, and the related congenital abnormalities pose significant management challenges. Surgical intervention is always essential, yet some complications are inevitable.

The Management of Pyromelic Polymelia in a Low-resource Setting: A Case Report

Introduction

Polymelia is the presence of supernumerary limbs attached to a segment of the body. It occurs in about 6/10,000 live births with 1.1/10,000 cases involving the lower limbs. It has a heterogeneous pathogenesis including incomplete separation of monozygotic twins.

Case Report

A 5-month-old baby with polymelia associated with ectopic right kidney, anorectal agenesis with a rectovaginal fistula, and right corneal opacity, delivered through cesarean section at 37 weeks, 3-day gestation to a 38-year-old mother. There were no known predisposing factors.

Conclusion

In the management of polymelia, a thorough clinical and radiological assessment to identify additional anomalies is critical, and early surgical intervention is safe and optimizes survival.

Parasitic limb excision in a neonate: a rare occurrence

Background

Parasitic limb is a rare congenital anomaly. Its incidence is less than 1 in 1 million live births. It refers to the type of conjoined twin in which tissues of an incompletely formed twin (parasite) are attached to and dependent upon a fully developed twin. Since it is a rare anomaly, all the cases should be reported.

Case presentation

This study reports a 3-day-old neonate admitted to the Children's Hospital Emergency. Her initial complaints were an extra limb arising from her lower back. She was born as a result of cousin marriage and was not diagnosed antenatally. The limb was attached to the lower lumbar region (L4, L5, S1). The limb was hypoplastic, and the baby was unable to hold it against the gravity but she cried when it was pinched suggesting pain sensations. Preoperative diagnostic workup was done, and parasitic limb was excised.

Conclusion

Every child with parasitic limb is a surgical dilemma. Thus, a multi-disciplinary approach and a carefully planned surgery with meticulous dissection can result in complete excision of a parasitic limb without any complications.

Successful management of a parasitic ischiopagus conjoined twins in a low-income setting

Ischiopagus parasites are fetal defects attached to a relatively normal twin by pelvis. This is the first reported case of parasitic ischiopagus twins without prenatal diagnosis successfully managed in Mozambique. A multidisciplinary team was involved in the supernumerary limbs excision. After 7 months, the infant has a normal development.

A case of cephalomelia discovered in a baby born in Niger

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.