Case Report
A baby within a man: A mysterious anomaly
Abdul Malek who has been diagnosed with Fetus in fetu, as the second reported case in Bangladesh with the condition.
When Abdul Malek, a 40 year old farmer from Shibgonj of Bogra district reported to Shaheed Ziaur Rahaman Medical College, Bogra, nobody could assume a mystery is going to be revealed. He was admitted with the complaints of abdominal swelling with a lump and recurrent abdominal pain since birth.
Initially he was suspected to have abdominal tumour. But when the doctors got the investigation reports, they were surprised to find an extremely rare condition. He was diagnosed as a case of "Fetus in fetu". The condition is a developmental anomaly in which a fetus (baby) is developed inside the body of another fetus during its development in the mother's womb.
In this case, a malformed fetus was intruded inside Abdul Malek's abdomen at the same time when he was developed as a fetus inside her mother's womb. So, Malek has been caring a fetus in his abdomen for last 40 years. The fetus is no one but his twin sibling (brother fetus), who has failed to develop a mature fetus and incorporate within his abdomen during intra-uterine life.
Since the first detection in late 18th century, about 90 cases have been reported worldwide so far. Malek is the second case in Bangladesh. The first one was reported 3 years ago in Bangabandhu Sheikh Mujib Medical University (BSMMU).
It is estimated to occur in 1 in 500,000 live births. It can occur in both sexes with male predominance, with most patients presenting with an abdominal mass in the first year of life with the oldest reported case being that of a 47-year-old man. The number of fetuses in fetu is usually single; however, multiple fetuses in fetu have been reported also.
In majority of cases, fetus develops in the abdomen. Other infrequent sites are skull cavity, orbit (eye cavity), scrotum etc. have been reported.
A fetus in fetu can be considered alive, but only in the sense that its component tissues have not yet died or been eliminated. All cases of fetus in fetu present critical defects, such as no functional brain, heart, lungs, gastrointestinal tract or urinary tract.
Actually, it has no prospect of any life outside the host. Usually it remains asymptomatic within the host. If it has detrimental effect to the life of the host twin, surgical excision is the recommended treatment and usually curative.