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Year : 2003  |  Volume : 13  |  Issue : 1  |  Page : 85-87
Fetus in fetu - a rare case


Dept. of Radiodiagnosis, Govt. Medical College, Nagpur, India

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Keywords: Fetus in Fetu, Salivary glands, teratoma

How to cite this article:
Taori K B, Khurana S D, Dhomne S P, Rathi V. Fetus in fetu - a rare case. Indian J Radiol Imaging 2003;13:85-7

How to cite this URL:
Taori K B, Khurana S D, Dhomne S P, Rathi V. Fetus in fetu - a rare case. Indian J Radiol Imaging [serial online] 2003 [cited 2019 Oct 23];13:85-7. Available from: http://www.ijri.org/text.asp?2003/13/1/85/28634
Fetus in fetu is a rare condition in which a fetiform calcified mass often is present in the abdomen of its host, a newborn or an infant. Approximately 87 reports have been documented in the literature to date. This is a unique case of Fetus in Fetu showing salivary glands.


   Case Report Top


A 5 months old girl was brought to the surgery department with complaints of gradually progressing distension of the abdomen [Figure - 1]. On plain radiograph of the abdomen there was a soft tissue density shadow in the abdomen displacing bowel loops to the left lower quadrant. There were well developed bony structures resembling long bones of the extremities possibly femur with small tubular bones seen. On USG, there was a mixed echogenic mass in the retroperitoneum with fat globules floating within along with rounded structures resembling undeveloped brain [Figure - 2].On Computed Tomographic study, there was a large retroperitoneal mass showing fatty, solid and bony components[Figure - 3]. Bony component resembled the shoulder girdle[Figure - 4]. The right kidney was displaced inferiorly. The diagnosis of fetus in fetu in the retroperitoneum was kept in mind. The patient was operated. On gross specimen of the tumor, it was was covered by a thin fibrous sac containing amber colored fluid along with an anencephalic fetus with four limb buds, limbs were showing well developed digits and nails [Figure - 5]. Histopathologically, the fetus consisted of fatty connective tissue with well identifiable blood vessels, neural tissue, salivary gland and skeletal muscles, gut with well developed mucosa, muscular coat and serosa was seen.This is a unique case of fetus in fetu showing a salivary gland.


   Discussion Top


Its pathogenesis, diagnosis and differentiation from teratoma have long been the subject of considerable controversy. Fetus in fetu is a term, which was first coined by Meckel to describe a rare condition in which a malformed parasitic twin was found inside the body of its partner usually in the abdominal cavity. However, recent reports state that fetus in fetu is a rare variant of teratoma itself and they are related entities, they possibly have the same development malformation [1]. It is said that this is a rare abnormality secondary to the abnormal embryogenesis in a diamniotic, monochorionic pregnancy; an unusual condition in which a vertebrate fetus is enclosed within the abdomen of a normally developing fetus [2]. This is an extremely uncommon cause of an abdominal mass in the neonate. The pathogenesis of the tumor may be related to sequestration of cells of the blastocyst before differential blocking of genome has occurred [3]. Fetus in fetu is detected most often in early infancy as in the present case. A wide range of age of presentation varying from immediate new born to as old as 27 years has however been documented [4]. The most common site of presentation was the retroperitoneum as in the present case. Other less common sites being the cranial cavity, pelvis, scrotal sac, sacrococcyx. mesentery and right iliac fossa. This case showed a vascular supply, which was derived from the right renal artery. In the previously reported cases the commonest visceral organ within the fetus was the gut, which correlated with the present case. However, various authors have described a wide variety of visceral organs including gonads, suprarenal glands, rudimentary lungs, heart larynx etc. The presence of salivary glandular tissue was a unique feature in the present case.

Recently a case of fetus in fetu with a rudimentary heart located in the sacrococcygeal region was reported [1].

Approximately 87 cases have been documented in literature to date. The increasing use of ultrasound and CT has identified more and more cases and also increasing use of obstetric ultrasound has made prenatal diagnosis of the condition, possible.

In our patient the imaging findings were diagnostic of this entity. The rarity of the condition and presence of salivary glands has made our case a unique one, as the association has not been reported earlier

 
   References Top

1.Kazez A, Ozercan IH, Erol FS, Faik Ozveren M, Parmaksiz E.: Sacrococcygeal heart: a very rare differentiation in teratoma. Eur J Pediatr Surg 2002 Aug; 12(4) : 278-80.   Back to cited text no. 1    
2.Patankar T, Fatterpekar GM, Prasad S, Maniyar A, Mukherji SK.: Fetus in fetu: CT appearance--report of two cases.; Radiology 2000 Mar; 214(3): 735-7  Back to cited text no. 2    
3.Sano K.: Intracranial dysembryogenetic tumors: pathogenesis and their order of malignancy. Neurosurg Rev 2001 Dec; 24(4): 162-7; discussion 168-70.  Back to cited text no. 3    
4.Massad MG, Kong L, Benedetti E, Resnick D, Ghosh L, Geha AS, Abcarian H.: Dysphagia caused by a fetus-in-fetu in a 27-year-old man. Ann Thorac Surg 2001 Apr; 71(4S): 1338-41.  Back to cited text no. 4    

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Correspondence Address:
K B Taori
Dept. of Radiodiagnosis, Govt. Medical College, Nagpur
India
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Source of Support: None, Conflict of Interest: None


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    Figures

[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4], [Figure - 5]

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