Single-center experience of fetus in fetu: A case series

Authors

  • G Habachi Pediatric surgery department Fattouma Bourguiba Hospital, Faculty of Medicine of Monastir Tunisia / research Laboratory LR12SP13
  • I Sabolic Division of Pediatric Surgery Department of Surgery University Hospital Center Zagreb Croatia
  • M Mesic Department of Pediatric Surgery, Children’s Hospital Zagreb Croatia
  • A Ksia Pediatric Surgery Department Monastir Tunisia
  • M ben Fredj Pediatric surgery department Fattouma Bourguiba Hospital, Faculty of Medicine of Monastir Tunisia / research Laboratory LR12SP13
  • S ben Youssef Pediatric surgery department Fattouma Bourguiba Hospital, Faculty of Medicine of Monastir Tunisia / research Laboratory LR12SP13
  • S Sfar Pediatric surgery department Fattouma Bourguiba Hospital, Faculty of Medicine of Monastir Tunisia / research Laboratory LR12SP13
  • N Kechiche Pediatric surgery department Fattouma Bourguiba Hospital, Faculty of Medicine of Monastir Tunisia / research Laboratory LR12SP13
  • R Lamiri Pediatric surgery department Fattouma Bourguiba Hospital, Faculty of Medicine of Monastir Tunisia / research Laboratory LR12SP13
  • M Mekki Pediatric surgery department Fattouma Bourguiba Hospital, Faculty of Medicine of Monastir Tunisia / research Laboratory LR12SP13
  • M Belghith Pediatric surgery department Fattouma Bourguiba Hospital, Faculty of Medicine of Monastir Tunisia / research Laboratory LR12SP13
  • M Messoud Pediatric surgery department Fattouma Bourguiba Hospital, Faculty of Medicine of Monastir Tunisia / research Laboratory LR12SP13
  • S Mosbahi Pediatric surgery department Fattouma Bourguiba Hospital, Faculty of Medicine of Monastir Tunisia / research Laboratory LR12SP13
  • L Sahnoun Pediatric surgery department Fattouma Bourguiba Hospital, Faculty of Medicine of Monastir Tunisia / research Laboratory LR12SP13

DOI:

https://doi.org/10.47338/jns.v13.1279

Keywords:

Fetus in fetu , Teratoma, Neonates

Abstract

Background: Fetus in fetu is a rare congenital malformation resulting from abnormal embryogenesis in a monochorionic diamniotic twinning gestation. This study aimed to document our experience with this anomaly in a developing country.

Methods: This retrospective analysis covers cases of fetus in fetu diagnosed at our institution between 1999 and 2023. Patients presenting with an intracorporeal mass containing a vertebral column and an appropriate arrangement of organs and limbs around the axis were included in the study.

Results: Five female patients with fetus in fetu were identified. The timing of diagnosis varied from incidental antenatal ultrasound discovery to postnatal abdominal mass presentation. The initial diagnosis involved radiological and serological investigations, confirmed by histopathology after surgical excision. The mean age at the time of surgery was 44 days. All patients underwent complete excision of the fetal mass, resulting in excellent postoperative outcomes and no recurrences.

Conclusion: Fetus in fetu is a pediatric rarity and must be distinguished from a teratoma mass, which carries a high malignant potential. Histological and genetic studies may contribute to understanding the pathogenesis and etiology of the disease.

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Author Biography

A Ksia, Pediatric Surgery Department Monastir Tunisia

Pediatric surgery department Fattouma Bourguiba Hospital, Faculty of Medicine of Monastir Tunisia / research Laboratory LR12SP13

References

Pang KK, Chao NS, Tsang TK, et al. From observation to aetiology: a case report of a twin fetus-in-fetu and a revisit of the known rarity. Hong Kong Med J. 2015;21(1):80-3. doi: 10.12809/hkmj133925.

McNamara HC, Kane SC, Craig JM, et al. A review of the mechanisms and evidence for typical and atypical twinning. Am J Obstet Gynecol. 2016;214(2):172-191. doi: 10.1016/j.ajog.2015.10.930. Epub 2015 Nov 6.

He Y, Ji Y, Xie G, et al. Retroperitoneal fetus in fetu presenting in a male infant: A case report and literature review. Radiol Case Rep. 2022;17(7):2408-2415. doi: 10.1016/j.radcr.2022.03.018.

Goodyear MD, Krleza-Jeric K, Lemmens T. The Declaration of Helsinki. BMJ. 2007;335(7621):624-5. doi: 10.1136/bmj.39339.610000.BE.

Willis RA. The structure of teratomata. J Pathol. 1935;40(1):1–36. doi: 10.1002/path.1700400102.

Gonzalez-Crussi F. Extragonadal Teratomas (Atlas of Tumor Pathology). 2nd Edition, Armed Forces Institute of Pathology, Washington DC. 1982.

Spencer R. Parasitic conjoined twins: external, internal (fetuses in fetu and teratomas), and detached (acardiacs). Clin Anat. 2001;14(6):428-44. doi: 10.1002/ca.1079.

Sharma S, Gupta PK, Regmi B, et al. Fetus in Fetu in an Adult Female and Brief Review of Literature. Case Rep Radiol. 2021;2021:6660277. doi: 10.1155/2021/6660277.

Bouyahia O, Bouafif E, Gharsallah L, et al. Foetus-in-fetu: an unusual cause of abdominal mass in the newborn. Acta Chir Belg. 2009;109(1):130-2. doi: 10.1080/00015458.2009.11680392.

Sitharama SA, Jindal B, Vuriti MK, et al. Fetus in Fetu: Case Report and Brief Review of Literature on Embryologic Origin, Clinical Presentation, Imaging and Differential Diagnosis. Pol J Radiol. 2017;82:46-49. doi: 10.12659/PJR.899956.

Dagradi AD, Mangiante GL, Serio GE, et al. Fetus in fetu removal in a 47-year-old man. Surgery. 1992;112(3):598-602.

Nicolini U, Dell'Agnola CA, Ferrazzi E, et al. Ultrasonic prenatal diagnosis of fetus in fetu. J Clin Ultrasound. 1983;11(6):321-2.

Shah R, Weil BR, Weldon CB, et al. Neonatal Malignant Disorders: Germ Cell Tumors. Clin Perinatol. 2021;48(1):147-165.

Traisrisilp K, Srisupundit K, Suwansirikul S, et al. Intracranial fetus-in-fetu with numerous fully developed organs. J Clin Ultrasound. 2018;46(7):487-493.

Şenyüz OF, Rizalar R, Celayir S, et al. Fetus in fetu or giant epignathus protruding from the mouth. J Pediatr Surg. 1992;27(12):1493-5.

Borges E, Lim-Dunham JE, Vade A. Fetus in fetu appearing as a prenatal neck mass. J Ultrasound Med. 2005;24(9):1313-6.

Alkhateeb M, Mashaqbeh M, Magableh S, et al. Early prenatal diagnosis of thoracopagus twins by ultrasound. Acta Inform Med. 2015;23(1):60-2.

Sanal M, Küçükçelebi A, Abasiyanik F, et al. Fetus in fetu and cystic rectal duplication in a newborn. Eur J Pediatr Surg. 1997;7(2):120-1.

Ji Y, Song B, Chen S, et al. Fetus in Fetu in the Scrotal Sac: Case Report and Literature Review. Medicine (Baltimore). 2015;94(32):e1322.

Kimmel DL, Moyer EK, et al. A cerebral tumor containing five human fetuses; a case of fetus in fetu. Anat Rec. 1950;106(2):141-65.

Gerber RE, Kamaya A, Miller SS, et al. Fetus in fetu: 11 fetoid forms in a single fetus: review of the literature and imaging. J Ultrasound Med. 2008 Sep;27(9):1381-7. doi: 10.7863/jum.2008.27.9.1381. Erratum in: J Ultrasound Med. 2008;27(11):1562. Madan, Ashima [added].

Parashari UC, Luthra G, Khanduri S, et al. Diagnostic dilemma in a neglected case of fetus-in-fetu solved with Magnetic Resonance Imaging and MDCT--a case report and review of literature. J Radiol Case Rep. 2011;5(10):29-37. doi: 10.3941/jrcr.v5i10.833.

Brand A, Alves MC, Saraiva C, et al. Fetus in fetu--diagnostic criteria and differential diagnosis--a case report and literature review. J Pediatr Surg. 2004;39(4):616-8. doi: 10.1016/j.jpedsurg.2003.12.029.

Pace S, Sacks MA, Goodman LF, et al. Antenatal Diagnosis of Retroperitoneal Cystic Mass: Fetiform Teratoma or Fetus in Fetu? A Case Report. Am J Case Rep. 2021;22:e929247. doi: 10.12659/AJCR.929247.

Kim YJ, Sohn SH, Lee JY, et al. Misdiagnosis of fetus-in-fetu as meconium peritonitis. Korean J Pediatr. 2011;54(3):133-6. doi: 10.3345/kjp.2011.54.3.133. Epub 2011 Mar 31.

Huddle LN, Fuller C, Powell T, et al. Intraventricular twin fetuses in fetu. J Neurosurg Pediatr. 2012;9(1):17-23. doi: 10.3171/2011.10.PEDS11196.

Hopkins KL, Dickson PK, Ball TI, et al. Fetus-in-fetu with malignant recurrence. J Pediatr Surg. 1997;32(10):1476-9. doi: 10.1016/s0022-3468(97)90567-4.

Wu Y, Jin X, Wu C, Wei G. Cardiac arrest in infant due to giant fetus-in-fetu. Thorax. 2021;76(1):100-101. doi: 10.1136/thoraxjnl-2020-215307. Epub 2020 Sep 22.

Taher HMA, Abdellatif M, Wishahy AMK, et al. Fetus in Fetu: Lessons Learned from a Large Multicenter Cohort Study. Eur J Pediatr Surg. 2020;30(4):343-349. doi: 10.1055/s-0039-1698765. Epub 2019 Nov 26.

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Published

2024-04-13

How to Cite

1.
Habachi G, Sabolic I, Mesic M, Ksia A, ben Fredj M, ben Youssef S, Sfar S, Kechiche N, Lamiri R, Mekki M, Belghith M, Messoud M, Mosbahi S, Sahnoun L. Single-center experience of fetus in fetu: A case series. J Neonatal Surg [Internet]. 2024Apr.13 [cited 2024Jul.21];13:17. Available from: https://jneonatalsurg.com/ojs/index.php/jns/article/view/1279