Fetus in fetu
Fetus in fetu is a rare and complex medical condition where a mass containing a vertebrate fetus is found inside the body of its twin. The condition is often mistaken for a teratoma, a type of tumor that can contain a variety of tissues, but fetus in fetu is characterized by the presence of a more organized body structure, including limbs, spine, and sometimes even organs. This condition is believed to result from an abnormality in the embryonic development, specifically a variation of monozygotic (identical) twin pregnancy.
Etiology
The exact cause of fetus in fetu is not fully understood, but it is thought to occur when one twin becomes enveloped by the other very early in pregnancy, within the first few weeks after conception. This phenomenon is a rare form of parasitic twin, where the enveloped twin becomes a parasite, surviving off the host twin's blood supply. Unlike conjoined twins, where both twins may share organs but have separate bodies, in fetus in fetu, the parasitic twin is enclosed within the body of the host twin.
Diagnosis
Diagnosis of fetus in fetu is challenging and often occurs incidentally during the investigation of a lump or mass in a child. Ultrasound, MRI, and CT scans are the primary imaging techniques used to identify the condition. These imaging tests can reveal the presence of a vertebrate mass, sometimes with recognizable body parts such as limbs or a spine, distinct from the surrounding tissue.
Symptoms
Symptoms of fetus in fetu vary depending on the size and location of the mass. Common symptoms include a palpable abdominal mass, abdominal pain, distension, and problems with bowel or bladder function. In some cases, the condition may be asymptomatic and discovered only during imaging tests for unrelated issues.
Treatment
The standard treatment for fetus in fetu is surgical removal of the mass. This procedure is necessary to prevent complications such as infection, obstruction of vital organs, and potential malignancy. The prognosis after surgery is generally good, with most individuals recovering fully.
Epidemiology
Fetus in fetu is extremely rare, with only about 200 reported cases in the medical literature. The condition occurs in approximately 1 in 500,000 live births. There is no known gender predilection.
Differential Diagnosis
Differential diagnosis for fetus in fetu includes teratoma, cystic hygroma, and other types of tumors. Distinguishing fetus in fetu from these conditions is crucial for appropriate management and treatment.
Conclusion
Fetus in fetu is a fascinating yet complex condition that challenges our understanding of human development and embryology. Ongoing research and advances in imaging technology continue to shed light on this rare phenomenon, improving diagnosis and treatment options for affected individuals.
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Contributors: Prab R. Tumpati, MD