We present a case of Fetus in Feto.
A detailed ultrasound examination revealed a 30-week female fetus with abdominal enlargement. The underlying cause of the abdominal enlargement was a right upper abdominal cyst that measured 100 x 80 x 90 mm and contained fluid (Image 1, 2, Video 1). Using tomographic ultrasound imaging (TUI), a heterogeneous mass could be identified suspended inside the cyst containing soft tissue, bone components, incomplete limbs, hypomineralized fluid-filled skull and a disfigured trunk (Image 3,4). A vascular stalk connects the parasitic twin to the wall of the sac and the color Doppler shows a single feeding vessel traversing this pedicle with a spectral Doppler pattern similar to the umbilical artery (Image 5,6).
The patient continued her pregnancy without complications and the fetus was delivered via Caesarean section with gentle extraction to avoid the rupture of the abdominal cyst. The baby was admitted to the neonatology unit of the Assiut University Children's Hospital due to mild respiratory distress. The baby was found to have elevated serum alpha fetoprotein. Conventional X-ray identified a soft tissue mass with a vertebral column and long bones within incomplete limbs. Computed tomography and CT angiography demonstrated an extraperitoneal sac in which a mass resembling a fetus could be seen (Image 7-9). The vertebral column and long bones of lower limbs could be identified easily, but there was no vascular pedicle indicating cessation of the blood flow to the parasitic twin.