TheFetus.net

Case of the Week #533

Fabrice Cuillier; Fabien Ho

Affiliation: Saint-Denis, Reunion island, French southern territories

Posting Dates: March 24, 2001 - April 7, 2021

Case Report: This was an incidental finding at 13 weeks gestation based on the last menstrual period. Previous personal, familial and obstetrical history was non contributory. Our ultrasound examination revealed the following anomalies:

1
Image 1
2
Image 2

Video 1
Video 2
Video 3
Video 4

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Answer

We present a case of conjoined twins, cephalothoracopagus type, with acrania.

Ultrasound images revealed the following:

  • Images 1 and 2 showed a complex mass with cranial defect, increased nuchal translucency and maybe a caudal defect as well.
  • Videos 1 and 2 (coronal sweep), showed that the mass featured a few facial bones, without any skull suggesting shared acrania, two spines forming a cone, a possible caudal defect, and a few limbs.
  • Videos 3 and 4 showed two hearts beating side by side as well as enlarged nuchal translucency.

The patient opted for termination of pregnancy. Macroscopic examination (Image 3) made the final diagnosis of conjoined twins, cephalothoracopagus type, with acrania.

3
Image 3: The twins have conjoined acrania with two eyes and a conjoined face. There is conjoined, enlarged thorax with two hearts and two upper limbs. The caudal poles are separate without defect, and include two lower limbs per twin, each with 3 segments.

Additional Reading:

Cuillier et al. "History, classification, and two cases of conjoined twins." TheFetus.net. https://thefetus.net/content/history-classification-and-two-cases-of-conjoined-twins, Publish date 01/2007.

Please also browse the Articles posted under "Multiple Gestations" and "Twins, conjoined" at TheFetus.net

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