Narayanasamy Jeyanthi N, Nallusamy Mohan Arunasalam, Baharuddin Nur Daliza
Department of General Surgery, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia
Department of General Surgery, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia.
J Surg Case Rep. 2014 Feb 18;2014(2). doi: 10.1093/jscr/rju001. Print 2014 Feb.
Fetus-in-fetu (FIF) is a rare entity resulting from abnormal embryogenesis in diamniotic monochorionic twins, being first described by Johann Friedrich Meckel (1800s). This occurs when a vertebrate fetus is enclosed in a normally growing fetus. Clinical manifestations vary. Detection is most often in infancy, the oldest reported age being 47. We report the case of a 4-day-old girl who was referred postnatally following a prenatal fetal scan which had revealed the presence of a multi-loculated retroperitoneal mass lesion with calcifications within. A provisional radiological diagnosis of FIF was made. Elective laparotomy revealed a well encapsulated retroperitoneal mass containing among other structures a skull vault and rudimentary limb buds. Recovery was uneventful. Here we discuss the difference between FIF and teratomas, risks of non-operative therapy and the role of serology in surveillance and detection of malignant change.
胎内胎是双羊膜单绒毛膜双胎异常胚胎发生导致的一种罕见实体，最早由约翰·弗里德里希·梅克尔（19世纪）描述。当一个脊椎动物胎儿被包裹在一个正常生长的胎儿体内时就会发生这种情况。临床表现各不相同。检测大多在婴儿期，报告的最大年龄为47岁。我们报告了一名4天大女婴的病例，该女婴在产前胎儿扫描显示存在一个多房性腹膜后肿块病变且内部有钙化后，于出生后被转诊。做出了胎内胎的初步放射学诊断。择期剖腹探查发现一个包膜完整的腹膜后肿块，其中除其他结构外还包含一个颅顶和发育不全的肢体芽。恢复过程顺利。在此我们讨论胎内胎与畸胎瘤的区别、非手术治疗的风险以及血清学在监测和检测恶性变化中的作用。
