Radiological-Pathological Comparison in a Case of Conjoined Gnatho-Thoracopagus Twins

Salmaso, Roberto; Manara, Renzo; Fassan, Matteo; Severino, Mariasavina; Visentin, Silvia; Macchi, Veronica; Cosmi, Erich

doi:10.1159/000253879

Cited by 6 publications

(4 citation statements)

References 29 publications

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“…Conjoined twins, including those connected through the mandible, were reported in human medicine. In these cases, it has been reported that symmetrical conjoined twins (gnatho-thoracopagus) were connected by an adhesion zone which started from the mandible and extended into the thoracic region (6,7). However, the present case reveals asymmetric conjoined twins in which autosite and parasite were connected to each other only through the mandibular regions.…”

Section: Asimetrik Yapışık Ikiz: Gnathopagus Parazitikuscontrasting

confidence: 47%

Asymmetric conjoined twins: Gnathopagus parasiticus

Kabak

Özak

et al. 2020

Ankara Üniversitesi Veteriner Fakültesi Dergisi

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In this study, a rare case of asymmetric conjoined twins that were connected to each other by their mandibles is described. There was an amorphous mass in between mandibles of the newborn calf. Radiological examination revealed that the amorphous mass consisted of a structure similar to the mandible and skull. According to the findings, the present anomaly was an asymmetric conjoined twins connected to each other by mandibles and named as gnathopagus parasiticus. Gnathopagus parasiticus case has not been reported in the literature previously.

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Section: Asimetrik Yapışık Ikiz: Gnathopagus Parazitikuscontrasting

confidence: 47%

Asymmetric conjoined twins: Gnathopagus parasiticus

Kabak

Özak

et al. 2020

Ankara Üniversitesi Veteriner Fakültesi Dergisi

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“…In the clinical evaluation of the present case of conjoined ischiopagus twins, the authors used a multidisciplinary approach similar to that applied to a case of gnatho-thoracopagus twins by Salmaso et al [12].…”

Section: Discussionmentioning

confidence: 99%

“…In cases of fetal demise, postmortem CT and MRI are able to realize a sort of virtual autopsy, so-called "virtopsy". It may represent an option to disclose fetal anatomy if the couple refuses to authorize the necropsy or may be useful in autopsy planning with specimen preservation [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Virtopsy in conjoined ischiopagus twins

Biso¹,

Sala²,

Vellone³

et al. 2017

Clin. Exp. Obstet. Gynecol.

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Purpose of investigation:To propose a multidisciplinary protocol for postmortem disclosure of complex fetal malformations, comparing ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and autopsy in a case of conjoined ischiopagus twins. Materials and Methods: A screening second-trimester ultrasound diagnosed ischiopagus twins at 20 gestational weeks in a 31year-old woman without any previous ultrasound examination. The couple decided for pregnancy termination. The formalin-fixed fetuses underwent full-body CT, MRI, and autopsy. Results: ultrasound accurately diagnosed ischiopagus twins. CT was very accurate in the description of bone components. MRI allowed better visualization of the visceral organs than CT. Only autopsy could disclose the aspect of the two gastrointestinal tracts and the external genitalia. Conclusions: Prenatal ultrasound represents the standard diagnostic exam for conjoined twins. CT-MRI virtual autopsy (virtopsy) may be an option if the couple refuses to authorize necropsy or may be useful to plan a minimally invasive autopsy preserving the external phenotype.

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“…Because of the scoliosis in the spine of the primary twin, it is possible that the two spines were originally oriented ventrally toward each other. Recently (Spencer and Robichaux,1998) a subtype of cephalopagus, prosopothoracopagus, was described where the conjunction begins more caudally and the conjoined twins have almost fully separate heads, like in the subclass gnathothoracopagus (Salmaso et al,2009). Kalchbrenner et al (1987) reported a case of prosopothoracopagus with two heads similar to those of the present case but oriented face to face.…”

Section: Discussionmentioning

confidence: 99%

Noninvasive investigation of asymmetrically conjoined tripus twins with features of rachipagus, parapagus dicephalus, and cephalopagus

et al. 2011

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A hypothetical mechanism for conjoined twinning postulated by Spencer ([2003] Developmental Malformations and Clinical Implications, Baltimore: Johns Hopkins University Press, p 1-476) suggests that, after separation, monovular twins fuse in one of eight predictable homologous sites. The tripus fetal specimen under study embodies characteristics of three types therefore preventing it from classification into a simple variant of any one of the eight twin types described by Spencer. The aim of this study was to reveal internal structural anomalies of the fetal specimen by using magnetic resonance imaging and computerized tomography. Dorsally appended to the primary twin is a secondary head mass (brain tissue and ocular globe) and two spinal columns converging at T4/T5, suggesting rachipagus twinning. The ventral orientation of the secondary twin's (right lateral) lower limb suggests parapagus twinning. The caudal divergence of the spinal columns and the presence of a secondary hemipelvis, separate from the primary pelvis, suggest cephalopagus twinning. Measurements of the long bones indicate a gestational age of ∼20-23 weeks. Secondary malformations of the primary fetal body include anencephaly, cleft palate, renal agenesis, decreased left ventricular outflow, and a prematurely terminating descending aorta. This study demonstrates the possibility of using current imaging techniques to study very old, formalin-preserved human material for documentation and scientific discussion without destroying the specimen, thus keeping it intact for posterity.

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Radiological-Pathological Comparison in a Case of Conjoined Gnatho-Thoracopagus Twins

Cited by 6 publications

References 29 publications

Asymmetric conjoined twins: Gnathopagus parasiticus

Asymmetric conjoined twins: Gnathopagus parasiticus

Virtopsy in conjoined ischiopagus twins

Noninvasive investigation of asymmetrically conjoined tripus twins with features of rachipagus, parapagus dicephalus, and cephalopagus

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