Souradip Mallick, National Institute of Technology, Rourkela
Fetus in fetu (FIF) has been defined as the presence of one of the twins in the body of the other. It is a condition in which malformed and parasitic fetus is located in the body of the normal fetus. It is very difficult for the radiologist to differentiate FIF from teratoma, a tumour made up of several different types of tissue, such as hair, muscle, teeth, or bone and other abdominal tumours.
Anatomically FIF is enclosed with distinct amniotic sac and attached to the auto site by a pedicle. It is a very rare condition of approximately 0.2 per million births. The diagnostic technologies like grayscale computed tomography (CT) which is radiation exposure that is why misdiagnosis has been reported very often.
For this purpose, a case was studied where “humanoid” FIF was diagnosed by multimode ultrasound (US) examination, with the use of contrast-enhanced ultrasound (CEUS). At first, the elevation of total bilirubin, direct bilirubin, indirect bilirubin, alpha-fetoprotein and non-specific enolase level laboratory report detect there is some abnormality in the blood test report. Later on, electrocardiography proves the oval foramen of the infant. After that CEUS, grayscale US and Colour Doppler flow imaging (CDFI) abdominal lesion of the infant and also revealed an aorta like structure, a limb-branch vessel-like structure and umbilical cord-like blood vessel. These imaging helps to find highly developed organs around the axial skeleton. This result distinguishes FIF from teratoma. Thus, identification of the vascular structure of the mass also helped in choosing appropriate surgical procedure and after successful surgery infant will recover soon.
Thus, it is concluded that multimodal US comprising grayscale high-frequency US, CDFI and CEUS avoids any type of radiation exposure, so it is the safe and useful and easy preoperative diagnostic approach of infant FIF.
Also read: IVIG:Intravenous Immunoglobulins in the treatment of COVID-19
Source: Hualin Yan; Juxian Liu; Yan Luo; Yang Wu; Lanxin Du. “Preoperative diagnosis of a “humanoid” fetus in fetu using multimode ultrasound: a case report” BMC Pediatrics ( IF 1.909 )2020-10-19, DOI: 10.1186/s12887-020-02389-y
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