Download PDF
Eur J Pediatr Surg 2020; 30(04): 343-349
DOI: 10.1055/s-0039-1698765
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Fetus in Fetu: Lessons Learned from a Large Multicenter Cohort Study

Heba M. A. Taher
1   Department of Pediatric Surgery, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt
,
Mostafa Abdellatif 
1   Department of Pediatric Surgery, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt
,
Ahmed Mohamed Kadry Wishahy
1   Department of Pediatric Surgery, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt
,
Saber Waheeb
2   Department of Pediatric Surgery, Alexandria University, Alexandria, Germany
,
Yasser Saadeldin
2   Department of Pediatric Surgery, Alexandria University, Alexandria, Germany
,
Sherif Kaddah
1   Department of Pediatric Surgery, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt
,
Ayman Hussein Abdulsattar
1   Department of Pediatric Surgery, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt
,
Mohamed Abdulkader Osman
3   Department of Pediatric Surgery, Assiut University, Assiut, Egypt
,
Gamal Hassan El Tagy
1   Department of Pediatric Surgery, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt
,
Mohamed M. Elbarbary
1   Department of Pediatric Surgery, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt
4   Department of Pediatric Surgery, Barbary Pediatric Surgery Clinic, Dokki, Giza, Egypt
,
Ahmad Khairi
2   Department of Pediatric Surgery, Alexandria University, Alexandria, Germany
,
Sherifa Tawfik
5   Department of Pathology, University of Lusaka, Lusaka, Zambia
6   Department of Pathology, Egypt Ministry of Health and Population, Cairo, Egypt
,
Shady Anis
7   Department of Pathology, Cairo University, Giza, Egypt
,
Elia Anis
7   Department of Pathology, Cairo University, Giza, Egypt
,
Moemn Farouk
1   Department of Pediatric Surgery, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt
,
Ahmed Hamdy Abdelfattah
1   Department of Pediatric Surgery, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt
,
Oliver J. Muensterer
8   Department of Pediatric Surgery, University Medicine Mainz, Mainz, Rhineland-Palatinate, Germany
› Author Affiliations Funding This study was financed entirely through intramural funding by the participating departments.
Further Information

Publication History

13 May 2019

02 September 2019

Publication Date:
26 November 2019 (online)

Also available at
    Permissions and Reprints

Abstract

Introduction Fetus in fetu (FIF) is an extremely rare condition of abnormal twinning during embryogenesis. Most publications are single case reports. We describe the combined experience of four large tertiary referral centers with FIF which were not previously reported or published, and thereby draw conclusions to establish criteria for the workup, diagnosis, and management including intraoperative risk.

Materials and Methods A survey was forwarded to a national pediatric surgery group which includes members from all pediatric surgery centers in the country enquiring about unpublished cases of FIF encountered over a 20-year interval. The cohort was analyzed for age of presentation, type of presentation, diagnostic workup, surgical management, and outcome.

Results From 1998 to 2018, a total of 10 FIF cases were included in the study. Mean age of presentation was 4 months. Computed tomography and ultrasound were the main preoperative diagnostic modality in our cohort. Resection of the mass was curative in nine cases. Two cases in which the FIF was in direct topographic proximity to the biliary tree suffered severe intraoperative or lethal postoperative complications.

Conclusion Complete excision of FIF is the treatment of choice and generally results in excellent long-term quality of life. Mortality is rare and may be associated with biliary involvement and retroperitoneal right upper quadrant location of the FIF tends to be associated with increased risk in excision, and there is also a possible association with the presence of immature elements in the pathology report.

Keywords

fetus in fetu - retroperitoneal - teratoma