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World Neurosurg. 2020 Apr 02;:
Authors: Surana A, Aggarwal A, Krishnan V, Malik A, Nair Misra R
Abstract
BACKGROUND: Intracranial fetus in fetu is an extremely rare entity in which a discrete vertebrate fetiform mass is found inside diamniotic monochorionic twin. It is a benign mass and can present with symptoms due to mass effect. To establish the diagnosis, there has to be a presence of vertebra within the mass.
CASE DESCRIPTION: We report a case of a five-year-old child who presented at a multi-specialty hospital with gradual weakness of bilateral lower limbs. Magnetic resonance imaging brain revealed a midline intraventricular mass with lobulated margins, having both cystic and fatty components with areas of blooming within. A provisional diagnosis of teratoma/ Primitive neuroectodermal tumor (PNET) was given. The patient presented to our hospital later with drowsiness and vomiting for one day. Non-contrast computed tomography revealed a heterogeneous density mass occupying the third ventricle, The mass contained few well-formed long bones representative of the appendicular skeleton and a vertebra like bone- representative of axial skeleton- fulfilling the Willis criteria. A biopsy was taken from the mass and no malignant cells were seen on histopathological examination. Based on NCCT findings of well-formed long bone and vertebra and no significant increase in the size of the mass in two years, the diagnosis of the intracranial fetus in fetu was given.
CONCLUSION: Whenever we identify bone structures in intracranial mass in the pediatric age group, we should always look for bones of axial skeleton as it will point towards a diagnosis of the intracranial fetus in fetu and will help in differentiating it from teratoma which can have malignant transformation.
PMID: 32247796 [PubMed - as supplied by publisher]
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