Fetus in fetu or giant epignathus protruding from the mouth

doi:10.1016/0022-3468(92)90480-U

Journal of Pediatric Surgery

Volume 27, Issue 12, December 1992, Pages 1493-1495

https://doi.org/10.1016/0022-3468(92)90480-U Get rights and content

Abstract

A huge and extremely organold mass, protruding from the mouth of a newborn and causing respiratory embarrassment, was resected. It was difficult to make a clear distinction whether this mass was fetus in fetu or a highly organoid epignathus dealing with the findings obtained from its gross and histological examination of the mass.

References (9)

A Ouimet et al.
Fetus in fetu or not?
J Pediatr Surg
(1989)
A Valente et al.
Neonatal tonsillar teratoma
J Pediatr Surg
(1988)
P Sutthiwan et al.
Fetus in fetu
J Pediatr Surg
(1983)
HL Eng et al.
Fetus in fetu: A case report and review of the literature
J Pediatr Surg
(1989)

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Cited by (48)

Retroperitoneal fetus in fetu presenting in a male infant: A case report and literature review
2022, Radiology Case Reports
Citation Excerpt :
Fetus in fetu, also known as cryptodidymus, is an extremely rare congenital disease caused by the abnormal development of monochorionic diamniotic twins, which has an incidence rate of 1 in 500,000 [1,2]. The disease was first described by Meckel [3] at the end of the 18th century, and was defined as a complete fetus parasitized by 1 or several incomplete fetuses. Due to the extremely low incidence rate, and there are currently no epidemiological statistics regarding the condition.
Fetus in fetu (FIF) is a rare congenital disease caused by the abnormal development of monochorionic diamniotic twins that appears as a cystic mass containing fetus-like structures mainly in the retroperitoneum of infants. The clinical manifestations of fetus in fetu vary, but they mostly present at infancy, hence, it should be differentiated from a teratoma. Here, we report a case of an infant with fetus in fetu in the retroperitoneum. Enhanced computed tomography scans and three-dimensional images showed a huge mixed-density mass on the left side of the abdominopelvic cavity with patchy distribution of fat, intact bones, and soft tissue. The child underwent fetus in fetu resection under general anaesthesia. Histopathology confirmed that the mass contained skin, muscle, intestinal mucosa, bones and cartilage, nerves, muscles, fat, and bone marrow tissue.
Fetus in fetu – a rare developmental anomaly
2019, Radiology Case Reports
Citation Excerpt :
And our case correctly matches the criteria. The term “fetus in fetu” was first described by Johann Friedrich Meckel during the late 18th century [3]. Later Willis described it as a rare condition where a parasitic twin resides in the body of its host usually the abdominal cavity [4].
Fetus in fetu is a rare condition which most often presents as a fetiform calcified mass in the abdomen of its host, fetus or newborn. We report a case of 8-month-old girl with history of abdominal distension. Ultrasonography and computed tomography scan revealed a mass in which the contents favor a fetus in fetu rather than a teratoma. She underwent surgery and the mass was resected in toto. Radiograph of the resected specimen showed the presence of rudimentary vertebral column which was later confirmed by pathologist.
Multisurgical approach for recurrent fetus-in-fetu of the skull
2018, Journal of Pediatric Surgery Case Reports
Foetus in fetu is a rare tumor of the child. CT and/or MRI suggest this diagnosis. Differential diagnosis with mature multicellular teratoma can be difficult. Here we reported the case of a girl born at 37 weeks, that presented a voluminous mastoïd mass on the left side treatment by initially by surgery. Until age of 9 years, she developed a tumor recurrence localized at the skull base near the left cerebello ponting angle requiring a neurosurgical approach with a good following. The pathology was finally a teratoma. Total removal must be a goal of the initial surgical treatment but a long term follow up is mandatory to avoid recurrence.
Perinatal management of congenital oropharyngeal tumors: The ex utero intrapartum treatment (EXIT) approach
2013, Journal of Pediatric Surgery
Citation Excerpt :
By definition, epignathi contain tissue elements derived from the three primitive embryonal germ layers (endoderm, mesoderm and ectoderm). Some cases have very well-differentiated organs and even a fetiform appearance, but those might be the result of an abnormal multiple gestation within the spectrum of cephalopagus conjoined twins and fetus in fetu rather than a true teratoma that arises from pluripotent cells [2–4]. Epignthi are usually benign tumors, but malignant components and aggressive behavior have been described [5,6].
To present our experience in the perinatal management of fetuses with large oropharyngeal tumors by ex utero intrapartum treatment (EXIT).
We performed a retrospective chart review of all patients with congenital oropharyngeal tumor who underwent an EXIT procedure between May 2006 and June 2012.
Four patients were included in the series, three females and one male. The diagnoses were epignathus (n = 2) and congenital epulis (n = 2). Three EXITs were done at term and one at late preterm due to premature rupture of membranes. Median maternal time under anesthesia was 185 min (range: 166–281) and median maternal operative time was 99 min (range: 85–153). Median maternal blood loss was 550 ml (range: 350–2000); one mother required a blood transfusion. Mean maternal hospital stay was 4 days. Median hysterotomy-to-cord clamp time was 24 min (range: 18–66). Mean fetal birth weight was 2.7 kg (range: 2.4–3). The airway was successfully accessed and secured under placental circulation in all cases. In the two patients with congenital epulis the tumors were resected at the base of their pedicles and the airway accessed via direct laryngoscopy before the umbilical cord was clamped. One patient with epignathus underwent a retrograde tracheal intubation under placental circulation and had the tumor resected thereafter. The second patient with epignathus had a tracheostomy done under placental circulation and then had tumor debulking immediately after the EXIT. The maternal morbidity was minimal and there were no mortalities.
We conclude that the EXIT procedure is the ideal delivery strategy for fetuses with prenatally diagnosed oropharyngeal tumors and potential airway obstruction at birth. Patients with prenatally diagnosed oropharyngeal tumors should be promptly referred to a fetal treatment center with a dedicated multidisciplinary team and EXIT capabilities.
Two cases of fetus in fetu
2011, Journal of Pediatric Surgery
Citation Excerpt :
Most of the reported FIF cases were in infancy [7], and the most frequent presentation is an abdominal mass, especially in upper retroperitoneum. Skull, scrotum, sacrum, lung, and mouth are other less frequently reported locations [3,8-10]. Three intrathoracic FIF cases were reported in the literature [3,11,12].
Fetus in fetu (FIF) is a rare cause of abdominal mass in children. One of the malformed monozygotic diamniotic twins is located in the body of other twin. It is differentiated from teratoma by the presence of vertebral organization with limb buds and other organ systems. Diagnosis is based on radiologic findings. Surgical excision is the treatment of choice, leading to the complete removal of the mass. To our knowledge, less than 200 cases have been described in the literature. Herein, we report 2 cases of FIF, a newborn who was diagnosed antenatally and a three-and-half-year- old boy diagnosed with mediastinal FIF after admission for recurrent respiratory tract infections.
Giant Epignathus Teratoma: Report of a Case
2007, Journal of Oral and Maxillofacial Surgery
Citation Excerpt :
Also, it is still not clear that an epignathus should have been classified as a mature teratoma or a parasitic fetus. Most of the literature referred to epignathus as a oropharyngeal or nasopharyngeal teratoma,10-14 some regarded it as a parasitic fetus.15,16 According to Coppit et al,17 the most widely accepted terminology in the classification of teratomas is that described by Arnold: “Dermoids, whose are the most common form of teratoma, are composed of ectoderm and mesoderm; teratoid tumors, whose form is rarely seen, are composed of ectoderm, mesoderm, and endoderm, and are characterized by poor differentiation.

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Fetus in fetu or giant epignathus protruding from the mouth

Abstract

J Pediatr Surg

J Pediatr Surg

J Pediatr Surg

J Pediatr Surg