PDF(Pubmed)
Abstract：
Fetus-in-fetu (FIF) is a rare congenital anomaly in which a malformed parasitic twin develops within the body of a live fetus or child. Abdominal teratoma, a type of germ cell tumor, can be a great imaging mimicker of FIF and vice-versa, as they both can present as a heterogeneous mass with calcifications and a fat component. Radiological differentiation of these 2 entities should be made because of the difference in surgical planning and treatment options. Features such as visualization of distinct bony vertebral elements and encysted cystic components are the specific features of Fetus in fetu [1]. In contrast, the presence of elevated serum markers can help diagnose teratoma. Here, we report a case of a 5-month-old girl presented with progressive distension of the upper abdomen for the last 2 months, noticed by her mother. Her initial imaging with abdominal X-ray and ultrasonography showed the presence of a large heterogenous solid-cystic mass in the upper abdomen with large elongated calcifications. A provisional diagnosis of teratoma vs FIF was considered. CECT abdomen showed clear identification of osseous structures of the axial and appendicular skeleton within a fat density mass, along with an encapsulated cystic component, strongly suggestive of FIF. Her serum tumor markers were within normal limits. The final diagnosis of FIF was confirmed on Laparotomy and postoperative specimens.
摘要：
胎儿胎儿（FIF）是一种罕见的先天性异常，其中畸形的寄生双胞胎在活胎儿或儿童的体内发育。腹部畸胎瘤,一种生殖细胞肿瘤,可以是一个很好的成像模拟FIF，反之亦然，因为它们都可以呈现为具有钙化和脂肪成分的异质团块。由于手术计划和治疗方案的差异，应进行这两个实体的放射学区分。特征，如不同的骨椎体和包膜囊性成分的可视化，是胎儿的特殊特征[1]。相比之下,血清标志物升高有助于畸胎瘤的诊断.这里,我们报告了一个5个月大的女孩在过去的2个月里表现为上腹部进行性扩张的病例，注意到她的母亲。她的腹部X射线和超声检查的初始成像显示，上腹部存在大量异质实性囊性肿块，并伴有大量细长钙化。考虑了畸胎瘤vsFIF的临时诊断。CECT腹部显示出脂肪密度团块内的轴向和附肢骨骼的骨结构的清晰识别，连同一个被包裹的囊性成分，强烈暗示FIF。她的血清肿瘤标志物在正常范围内。在剖腹手术和术后标本上证实了FIF的最终诊断。
