Fetus in fetu: A rare case report
A two month-old girl was admitted to New Medical College Hospital, Kota, India in January 2011. Her parents complained about a gradually increasing lump in her right upper abdomen since birth which was extending up to the right iliac fossa. There was no history of maternal illness, exposure to radiation, or drug intake during pregnancy. There was no family history of multiple pregnancies. There was no other gastrointestinal or genitourinary symptom. At clinical examination, a bulky, firm, rounded mass of 10×12 cm2 was palpated in the right hypochondrium. The plain abdominal radiograph revealed a right-upper quadrant mass containing calcified densities identifiable as fetal parts (). Intravenous urography showed a retroperitoneal extra renal mass. Ultrasound examination and abdominal computed tomography revealed a large mass with cystic and solid calcified components in the retroperitoneum.\nLaparotomy was performed through a transverse supraumbilical incision. At surgery, a thin-walled cystic mass was found in the retroperitoneal region which compressed the inferior vena cava and medially displaced the duodenum. The tumor was entirely enveloped by a saclike capsule with an umbilical cord () which connected the mass to the branch of abdominal aorta. After ligation and section of the cord, the mass was easily and completely removed (). By opening the capsule, a fetiform structure floating in yellowish fluid was observed. Symmetrical, well-developed lower limbs with structures resembling toes were present bilaterally. Upper limbs were also present, but were rudimentary in form. A further radiograph confirmed these observations. Histopathological examination revealed the presence of brain tissue, gut-like structures, fingers, and limbs. The mass was finally confirmed as fetus in fetu.