Intrahepatic fetus-in-fetu: A case report and review of the literature

The authors report the third case since 1964 of fetus-in-fetu presenting at Red Cross Children's Hospital. A fetal liver abnormality was detected duri ng routine antenatal ultrasound scan, and the postnatal diagnosis of an int rahepatic, multiple fetus-in-fetu was made with abdominal ultrasound scan, plain radiograph of the abdomen and computed tomography. The mass was remov ed surgically by hemihepatectomy when the patient was 4 months of age. Imag ing and the macroscopic and microscopic appearances of the abnormality conf irmed the diagnosis and amplified it to include an adjacent teratoma. Multi ple small subcapsular and perimass vascular hamartomas were coincidentally discovered in the liver. Two of the 3 nodules within the amniotic-lined cav ity of the intrahepatic mass individually comply with the accepted criteria for fetus-in-fetu, and the third nodule has the accepted features of a ben ign teratoma. The existence of multiple fetus-in-fetu and fetus-in-fetu com bined with a teratoma, is recorded in the medical literature. The imaging a s well as the macroscopic and microscopic features are illustrated. J Pedia tr Surg 34:1861-1864. Copyright (C) 1999 by W.B. Saunders Company.