Neonatology and Perinatology

Biography

Isabela Barros is an intern in IMIP (Professor Fernando Figueira Integral Medicine Institute) and medical student in Faculdade Pernambucana de Saúde. Dr Barros
has concluded a one-year program in pediatric surgery in IMIP, which is a reference in pediatrics and pediatric surgery in Brazil and has worked in partnership with
WHO recognized institutions, has also concluded internships in the US and the UK.

Abstract

Introduction: Fetus in fetu (FIF) is an extremely rare congenital anomaly, the estimated incidence is 1 to 500,000 births. It is
the result of abnormal development of monochorionic and diamniotic twins, where a parasitic twin is incorporated into the
body of the host twin. Less than 200 cases were described in literature, in 1953 Willis defined it as a mass containing a vertebral
axis and with highly developed organogenesis. Less than 10% of the patients present with the lack of vertebral axle, in this cases
the differential diagnosis is made based on other findings. Treatment consists of complete resection.
Methods: Data was collected by medical records, interview with the patient’s responsible, patients and diagnostic exams. The
review of the literature occurred through the PubMed database.
Results: Eight year old female patient, presenting with palpable and painless abdominal mass in the left flank since first
months of life, progressively increasing. At 8 years, after unspecific symptoms (vomiting and fever) sought the emergency,
after investigation a tomography of abdomen was performed, showing a tumor, measuring 15.0 x 10.0 x 8.5 cm, suggesting
tumor of dermoid lineage or fetus in fetu. Alpha-fetoprotein and human chorionic gonadotropin (hCG) levels were normal.
She underwent surgery with complete resection of right retroperitoneal mass. The anatomopathological study evidenced a
tumor measuring 14.5 x 9.0 x 8.0 cm and weighing 624 g. Macroscopically, it was possible to recognize a structure with an
appearance of an eyeball, sketch of mouth with teeth and central bone axis with bone marrow, without specific identification
of vertebral axle. Microscopically, there was organogenesis, with confirmation of ocular structure, besides the presence of skin,
odontogenesis and salivary glands, among other tissues.
Conclusion: Considering the controversy between extremely differentiated teratoma and fetus in fetu, the presence of well
differentiated organogenesis around an axial axis, in this case, corroborates the diagnosis of FIF, even in the absence of a
vertebral axle. This is a rare clinical presentation