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Case Reports: Rare disease
Fetus in fetu: use of intraoperative ultrasound for safe excision of a rare entity
  1. Darci C Foote1,
  2. Alyssa Kirsch2,
  3. Terrence Metz2 and
  4. Pavan Brahmamdam1
  1. 1Surgery, Beaumont Health, Royal Oak, Michigan, USA
  2. 2Radiology, Beaumont Health, Royal Oak, Michigan, USA
  1. Correspondence to Dr Pavan Brahmamdam; pavan.brahmamdam{at}beaumont.org

Abstract

A prenatally diagnosed abdominal mass at 36 weeks and 0 days was further characterised by postnatal ultrasound and MRI to be likely a rare case of fetus in fetu in an otherwise healthy male. Due to close proximity to both the coeliac axis and superior mesenteric artery (SMA), surgical excision was delayed for several months. Interim CT with intravenous contrast performed at 2 months of age demonstrated the SMA travelling through the posterior aspect of the mass. Surgery proceeded at 2 months of age. Intraoperative ultrasound was used to definitively identify both the coeliac axis and SMA in order to facilitate a safe excision. The patient recovered well with an uneventful discharge to home on postoperative day 8. Pathology confirmed the diagnosis of fetus in fetu.

  • congenital disorders
  • radiology
  • paediatric surgery
  • ultrasonography

https://doi.org/10.1136/bcr-2021-245371

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    Footnotes

    • DCF and AK are joint first authors.

    • Contributors All authors were actively involved in the patient’s care. DCF and PB were involved in surgical management. AK and TM were involved in radiologic interpretation. TM performed intraoperative ultrasound during the case. All authors drafted and critically revised the manuscript, have given final approval for publication, and agree to be accountable for the integrity of the report. DCF and AK contributed equally and are co-first authors of this manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.