Fetus in Fetu: Lessons Learned from a Large Multicenter Cohort Study

Heba M. A. Taher; Mostafa Abdellatif; Ahmed Mohamed Kadry Wishahy; Saber Waheeb; Yasser Saadeldin; Sherif Kaddah; Ayman Hussein Abdulsattar; Mohamed Abdulkader Osman; Gamal Hassan El Tagy; Mohamed M. Elbarbary; Ahmad Khairi; Sherifa Tawfik; Shady Anis; Elia Anis; Moemn Farouk; Ahmed Hamdy Abdelfattah; Oliver J. Muensterer

doi:10.1055/s-0039-1698765

European Journal of Pediatric Surgery, Table of Contents

Eur J Pediatr Surg 2020; 30(04): 343-349
DOI: 10.1055/s-0039-1698765

Original Article

Georg Thieme Verlag KG Stuttgart · New York

Fetus in Fetu: Lessons Learned from a Large Multicenter Cohort Study

Authors

Heba M. A. Taher

¹Department of Pediatric Surgery, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt
Mostafa Abdellatif

¹Department of Pediatric Surgery, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt
Ahmed Mohamed Kadry Wishahy

¹Department of Pediatric Surgery, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt
Saber Waheeb

²Department of Pediatric Surgery, Alexandria University, Alexandria, Germany
Yasser Saadeldin

²Department of Pediatric Surgery, Alexandria University, Alexandria, Germany
Sherif Kaddah

¹Department of Pediatric Surgery, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt
Ayman Hussein Abdulsattar

¹Department of Pediatric Surgery, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt
Mohamed Abdulkader Osman

³Department of Pediatric Surgery, Assiut University, Assiut, Egypt
Gamal Hassan El Tagy

¹Department of Pediatric Surgery, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt
Mohamed M. Elbarbary

¹Department of Pediatric Surgery, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt

⁴Department of Pediatric Surgery, Barbary Pediatric Surgery Clinic, Dokki, Giza, Egypt
Ahmad Khairi

²Department of Pediatric Surgery, Alexandria University, Alexandria, Germany
Sherifa Tawfik

⁵Department of Pathology, University of Lusaka, Lusaka, Zambia

⁶Department of Pathology, Egypt Ministry of Health and Population, Cairo, Egypt
Shady Anis

⁷Department of Pathology, Cairo University, Giza, Egypt
Elia Anis

⁷Department of Pathology, Cairo University, Giza, Egypt
Moemn Farouk

¹Department of Pediatric Surgery, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt
Ahmed Hamdy Abdelfattah

¹Department of Pediatric Surgery, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt
Oliver J. Muensterer

⁸Department of Pediatric Surgery, University Medicine Mainz, Mainz, Rhineland-Palatinate, Germany

Abstract

Introduction Fetus in fetu (FIF) is an extremely rare condition of abnormal twinning during embryogenesis. Most publications are single case reports. We describe the combined experience of four large tertiary referral centers with FIF which were not previously reported or published, and thereby draw conclusions to establish criteria for the workup, diagnosis, and management including intraoperative risk.

Materials and Methods A survey was forwarded to a national pediatric surgery group which includes members from all pediatric surgery centers in the country enquiring about unpublished cases of FIF encountered over a 20-year interval. The cohort was analyzed for age of presentation, type of presentation, diagnostic workup, surgical management, and outcome.

Results From 1998 to 2018, a total of 10 FIF cases were included in the study. Mean age of presentation was 4 months. Computed tomography and ultrasound were the main preoperative diagnostic modality in our cohort. Resection of the mass was curative in nine cases. Two cases in which the FIF was in direct topographic proximity to the biliary tree suffered severe intraoperative or lethal postoperative complications.

Conclusion Complete excision of FIF is the treatment of choice and generally results in excellent long-term quality of life. Mortality is rare and may be associated with biliary involvement and retroperitoneal right upper quadrant location of the FIF tends to be associated with increased risk in excision, and there is also a possible association with the presence of immature elements in the pathology report.

Keywords

fetus in fetu - retroperitoneal - teratoma

Full Text

References

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