Fetus-in-fetu in the cranium of a 4-month-old boy: histopathology and short tandem repeat polymorphism–based genotyping

Case report

Jin Wook Kim M.D. 1 , Sung-Hye Park M.D., Ph.D. 2 , Sung-Sup Park M.D., Ph.D. 3 , Kyu-Chang Wang M.D., Ph.D. 1 , Byung-Kyu Cho M.D., Ph.D. 1 , So Yeon Kim M.D. 3 , Eun Kyung Ra M.S. 3 , Chae-Yong Kim M.D., Ph.D. 4 , and Seung-Ki Kim M.D., Ph.D. 1
View More View Less
  • 1 Division of Pediatric Neurosurgery and
  • 2 Department of Pathology, Seoul National University Children's Hospital;
  • 3 Department of Laboratory Medicine, Seoul National University Hospital, Seoul; and
  • 4 Department of Neurosurgery, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00
Print or Print + Online

✓Fetus-in-fetu is a very rare condition in which one fetus is contained within another. About 100 cases have been reported, and in most of these the fetus was located in the retroperitoneum. The authors describe an extremely rare case of an intracranial fetus-in-fetu in an extraaxial location. This is the eighth intracranial fetus-in-fetu to be reported, the first intracranial extraaxial case, and involves the oldest documented patient with this condition.

Histopathological analysis of the mass revealed a degenerated amnionic membranelike tissue, well-differentiated extremities (including fingerlike structures), skin, matured lungs, well-formed intestines, cerebellar and cerebral tissue, and a notochord with ganglion cells. DNA analysis using short tandem repeat polymorphisms confirmed that the fetus-in-fetu mass and the host infant had heterozygous alleles and were of identical sex and genotype.

Abbreviations used in this paper: CT = computed tomography; MR = magnetic resonance; STR = short tandem repeat.

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00

Contributor Notes

Address correspondence to: Seung-Ki Kim, M.D., Ph.D., Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, 103 Daehangno, Jongno-gu, Seoul 110-799, Republic of Korea. email: nsthomas@snu.ac.kr.
  • 1

    Afshar F, , King TT, & Berry CL: Intraventricular fetus-in-fetu. Case report. J Neurosurg 56:845849, 1982

  • 2

    Bär W, , Brinkmann B, , Budowle B, , Carracedo A, , Gill P, & Lincoln P, : DNA recommendations. Further report of the DNA Commission of the ISFH regarding the use of short tandem repeat systems International Society for Forensic Haemogenetics. Int J Legal Med 110:175176, 1997

    • Search Google Scholar
    • Export Citation
  • 3

    Brand A, , Alves MC, , Saraiva C, , Loío P, , Goulão J, & Malta J, : Fetus in fetu—diagnostic criteria and differential diagnosis—a case report and literature review. J Pediatr Surg 39:616618, 2004

    • Search Google Scholar
    • Export Citation
  • 4

    Chua JH, , Chui CH, , Sai Prasad TR, , Jabcobsen AS, , Meenakshi A, & Hwang WS: Fetus-in-fetu in the pelvis: report of a case and literature review. Ann Acad Med Singapore 34:646649, 2005

    • Search Google Scholar
    • Export Citation
  • 5

    Coolen J, , Bradshaw B, , Bhargava R, , Lees G, & Demianczuk N: Fetus-in-fetu: confirmation of prenatal diagnosis with MRI. Prenat Diagn 27:7376, 2007

    • Search Google Scholar
    • Export Citation
  • 6

    Goldstein I, , Jakobi P, , Groisman G, & Itskovitz-Eldor J: Intracranial fetus-in-fetu. Am J Obstet Gynecol 175:13891390, 1996

  • 7

    Hing A, , Corteville J, , Foglia RP, , Bliss DP Jr, , Donis-Keller H, & Dowton SB: Fetus in fetu: molecular analysis of a fetiform mass. Am J Med Genet 47:333341, 1993

    • Search Google Scholar
    • Export Citation
  • 8

    Hoeffel CC, , Nguyen KQ, , Phan HT, , Truong NH, , Nguyen TS, & Tran TT, : Fetus in fetu: a case report and literature review. Pediatrics 105:13351344, 2000

    • Search Google Scholar
    • Export Citation
  • 9

    Hong SS, , Goo HW, , Jung MR, , Kim HJ, , Kim EA, & Kim KS, : Fetus in fetu: three-dimensional imaging using multidetector CT. AJR Am J Roentgenol 179:14811483, 2002

    • Search Google Scholar
    • Export Citation
  • 10

    Hopkins KL, , Dickson PK, , Ball TI, , Ricketts RR, , O'Shea PA, & Abramowsky CR: Fetus-in-fetu with malignant recurrence. J Pediatr Surg 32:14761479, 1997

    • Search Google Scholar
    • Export Citation
  • 11

    Hung CF, & Lam MS: Intracranial fetus in fetu: report of a case. J Formos Med Assoc 92:920922, 1993

  • 12

    Kimmel DL, , Moyer EK, , Peale AR, , Winborne LW, & Gotwals JE: A cerebral tumor containing five human fetuses; a case of fetus in fetu. Anat Rec 106:141165, 1950

    • Search Google Scholar
    • Export Citation
  • 13

    Kimpton CP, , Gill P, , Walton A, , Urquhart A, , Millican ES, & Adams M: Automated DNA profiling employing multiplex amplification of short tandem repeat loci. PCR Methods Appl 3:1322, 1993

    • Search Google Scholar
    • Export Citation
  • 14

    Miura S, , Miura K, , Yamamoto T, , Yamanaka M, , Saito K, & Hirabuki T, : Origin and mechanisms of formation of fetus-in-fetu: two cases with genotype and methylation analyses. Am J Med Genet A 140:17371743, 2006

    • Search Google Scholar
    • Export Citation
  • 15

    Mutter GL: Teratoma genetics and stem cells: a review. Obstet Gynecol Surv 42:661670, 1987

  • 16

    Tsai CH, , Lin JS, & Tsai FJ: Intraventricular fetus in fetu: report of one case. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi 34:143150, 1993

    • Search Google Scholar
    • Export Citation
  • 17

    Wu JT, , Book L, & Sudar K: Serum alpha fetoprotein (AFP) levels in normal infants. Pediatr Res 15:5052, 1981

  • 18

    Yang ST, & Leow SW: Intracranial fetus-in-fetu: CT diagnosis. AJNR Am J Neuroradiol 13:13261329, 1992

Metrics

All Time Past Year Past 30 Days
Abstract Views 433 196 11
Full Text Views 43 3 0
PDF Downloads 44 5 0
EPUB Downloads 0 0 0