Skip to main content

Advertisement

Log in

Antenatal diagnosis of a third ventricular mass: fetus in fetu or teratoma?

  • Case-based Update
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Background

Fetus in fetu (FIF) is a rare condition in medicine where an aberrant monozygotic twining results in inclusion of a degenerated fetus inside its twin bearer. Whereas FIF is generally defined as a fetiform vertebrate mass, teratoma is considered as a tumor composed of disorganized tissues derived from the three embryological layers. Recent data plead for a common origin and suggest a continuum between FIF and teratoma.

Case history

We describe the case of an intraventricular mass diagnosed by prenatal imaging and associated with triventricular hydrocephalus. Surgical removal of a non-vertebrate mass covered by normal skin was performed when the child was 15 months old. Now aged of 30 months, the child continues to develop normally. Histological data were in favor of a FIF.

Discussion

We discuss the diagnosis, pathogenesis, and prognosis in the light of data from the recent literature.

Conclusions

Aberrant monozygotic twining leading to inclusion of a degenerate fetus inside its twin bearer results in FIF or teratomas. Surgical removal represents the main treatment. Intracranial FIF remains an extremely rare congenital condition, with a favorable oncological prognosis; the developmental prognosis appears conditioned by the absence of other malformation, the small size of the lesion, and the early management of intracranial hypertension.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Afshar F, King TT, Berry CL (1982) Intraventricular fetus-in-fetu. Case report. J Neurosurg 56(6):845–849

    PubMed  CAS  Google Scholar 

  2. Beaudoin S, Gouizi G, Mezzine S, Wann AR, Barbet P (2004) Mediastinal fetus in fetu. Case report and embryological discussion. Fetal Diagn Ther 19(5):453–455

    Article  PubMed  CAS  Google Scholar 

  3. Borges E, Lim-Dunham JE, Vade A (2005) Fetus in fetu appearing as a prenatal neck mass. J Ultrasound Med 24(9):1313–1316

    PubMed  Google Scholar 

  4. de Lagausie P, de Napoli Cocci S, Stempfle N, Truong QD, Vuillard E, Ferkadji L, Aigrain Y (1997) Highly differentiated teratoma and fetus-in-fetu: a single pathology. J Pediatr Surg 32(1):115–116

    Article  PubMed  Google Scholar 

  5. Fiedler J, Röse I (1974) Intracranial teratoma with fetuses in fetu of a premature stillborn (author’s transl). Zentralbl Allg Pathol 118(1):23–29

    PubMed  CAS  Google Scholar 

  6. Goldstein I, Jakobi P, Groisman G, Itskovitz-Eldor J (1996) Intracranial fetus-in-fetu. Am J Obstet Gynecol 175(5):1389–1390

    Article  PubMed  CAS  Google Scholar 

  7. Gonzales-Crussi F (1982) Extragonadal teratomas. Atlas of tumor pathology. 2nd ser., fasc. 18. Armed Forces Institute of Pathology, Washington, DC

    Google Scholar 

  8. Gould G, Pyle W (1896) Anomalies and curiosities of medicine. WB Saunders, Philadelphia, PA

    Google Scholar 

  9. Grant P, Pearn JH (1969) Foetus-in-foetu. Med J Aust 1(20):1016–1019

    PubMed  CAS  Google Scholar 

  10. Grosfeld JL, Stepita DS, Nance WE, Palmer CG (1974) Fetus-in-fetu: an unusual cause for abdominal mass in infancy. Ann Surg 180(1):80–84

    Article  PubMed  CAS  Google Scholar 

  11. Hanquinet S, Damry N, Heimann P, Delaet MH, Perlmutter N (1997) Association of a fetus in fetu and two teratomas: US and MRI. Pediatr Radiol 27(4):336–338

    Article  PubMed  CAS  Google Scholar 

  12. Heifetz SA, Alrabeeah A, Brown BS, Lau H (1988) Fetus in fetu: a fetiform teratoma. Pediatr Pathol 8(2):215–226

    Article  PubMed  CAS  Google Scholar 

  13. Heuer GG, Schwartz ES, Storm PB (2008) Cranial fetus in fetu. J Neurosurg Pediatrics 1:171

    Article  PubMed  Google Scholar 

  14. Higgins KR, Coley BD (2006) Fetus in fetu and fetaform teratoma in 2 neonates: an embryologic spectrum. J Ultrasound Med 25(2):259–263

    PubMed  Google Scholar 

  15. Hoeffel CC, Nguyen KQ, Phan HT, Truong NH, Nguyen TS, Tran TT, Fornes P (2000) Fetus in fetu: a case report and literature review. Pediatrics 105(6):1335–1344

    Article  PubMed  CAS  Google Scholar 

  16. Hopkins KL, Dickson PK, Ball TI, Ricketts RR, O’Shea PA, Abramowsky CR (1997) Fetus-in-fetu with malignant recurrence. J Pediatr Surg 32(10):1476–1479

    Article  PubMed  CAS  Google Scholar 

  17. Ianniruberto A, Rossi P, Ianniruberto M, Rella G, Ciminelli V (2001) Sonographic prenatal diagnosis of intracranial fetus in fetu. Ultrasound Obstet Gynecol 18(1):67–68

    Article  PubMed  CAS  Google Scholar 

  18. Kim OH, Shinn KS (1993) Postnatal growth of fetus-in-fetu. Pediatr Radiol 23(5):411–412

    Article  PubMed  CAS  Google Scholar 

  19. Kimmel DL, Moyer EK, Peale AR, Winborne LW, Gotwals E (1950) A cerebral tumor containing five human fetuses; a case of fetus in fetu. Anat Rec 106(2):141–165

    Article  PubMed  CAS  Google Scholar 

  20. Lee EY (1965) Foetus in foetu. Arch Dis Child 40(214):689–693

    Article  PubMed  CAS  Google Scholar 

  21. Lewis RH (1961) Foetus in foetu and the retroperitoneal teratoma. Arch Dis Child 36:220–226

    Article  PubMed  CAS  Google Scholar 

  22. Linder D, McCaw BK, Hecht F (1975) Parthenogenic origin of benign ovarian teratomas. N Engl J Med 292(2):63–66

    PubMed  CAS  Google Scholar 

  23. Lord JM (1956) Intraabdominal fetus in fetu. J Pathol Bacteriol 72:627–641

    Article  Google Scholar 

  24. Mills P, Bornick PW, Morales WJ, Allen M, Gilbert-Barness E, Johnson PK, Quintero R (2001) Ultrasound prenatal diagnosis of fetus in fetu. Ultrasound Obstet Gynecol 18(1):69–71

    Article  PubMed  CAS  Google Scholar 

  25. Mutter GL (1987) Teratoma genetics and stem cells: a review. Obstet Gynecol Surv 42(11):661–670

    Article  PubMed  CAS  Google Scholar 

  26. Naudin ten Cate L, Vermeij-Keers C, Smit DA, Cohen-Overbeek TE, Gerssen-Schoorl KB, Dijkhuizen T (1995) Intracranial teratoma with multiple fetuses: pre- and post-natal appearance. Hum Pathol 26(7):804–807

    Article  PubMed  CAS  Google Scholar 

  27. Povýsilová V (1983) Encranius with multiple rudimentary fetus in fetu in a premature boy. Cesk Patol 19(1):49–54

    PubMed  Google Scholar 

  28. Saito K, Katsumata Y, Hirabuki T, Kato K, Yamanaka M (2007) Fetus-in-fetu: parasite or neoplasm? A study of two cases. Fetal Diagn Ther 22(5):383–388

    Article  PubMed  Google Scholar 

  29. Shin JH, Yoon CH, Cho KS, Lim SD, Kim EA, Kim KS, Pi SY, Auh YH (1999) Fetus-in-fetu in the scrotal sac of a newborn infant: imaging, surgical and pathological findings. Eur Radiol 9(5):945–947

    Article  PubMed  CAS  Google Scholar 

  30. Spencer R (2001) Parasitic conjoined twins: external, internal (fetuses in fetu and teratomas), and detached (acardiacs). Clin Anat 14(6):428–444

    Article  PubMed  CAS  Google Scholar 

  31. Tsai CH, Lin JS, Tsai FJ (1993) Intraventricular fetus in fetu: report of one case. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi 34(2):143–150

    PubMed  CAS  Google Scholar 

  32. Weiss JR, Burgess JR, Kaplan KJ (2006) Fetiform teratoma (homunculus). Arch Pathol Lab Med 130(10):1552–1556

    PubMed  Google Scholar 

  33. Willis R (1935) The structure of teratomata. J Pathol Bacteriol 40:1–36

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Dominique Marnet.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Marnet, D., Vinchon, M., Kerdraon, O. et al. Antenatal diagnosis of a third ventricular mass: fetus in fetu or teratoma?. Childs Nerv Syst 24, 887–891 (2008). https://doi.org/10.1007/s00381-008-0641-5

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-008-0641-5

Keywords

Navigation