Giant retroperitoneal fetus-in-fetu: An unusual cause of respiratory distress

Abstract

Fetus-in-fetu (FIF) is a rare congenital condition in which a vertebrate fetus is incorporated within its host, a newborn or an infant. We report an interesting case of FIF presenting as an abdominal mass with respiratory distress in a 4-month-old girl, and review the existing literature. An ultrasound abdomen showed a right sided cystic mass containing multiple calcifications. Laparotomy revealed a well-encapsulated right retroperitoneal mass above the right kidney with two rudimentary limbs attached to an amniotic bag by an umbilical cord. Excision of the capsule revealed a yellowish fluid and an incompletely developed fetus covered by vernix caseosa. Pathologic examination showed an irregular fetiforme mass, weighing 1200 gm, with two rudimentary limbs, encephalus, stomach, duodenum, bowel, bone, cartilage, bone marrow, upper and lower respiratory tissue, and spleen. Complete excision of the FIF was performed. The postoperative period was uneventful and the patient was discharged on the seventh postoperative day.

Fetus in Fetu (Pre-surgical dilemma: Review of literature and a case report)

“…3 Other uncommon organs reported are thyroid, parathyroid, pancreas, spleen, kidney, adrenal, testis, ovaries, urinary bladder, tongue, salivary glands, lymphnodes, trachea, lower respiratory tissue, teeth, digits and nails. 2,6,7 Histopathologically, the fetus consisting 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 has been found. 2 There has been reports of multiple FIF in the same mass.…”