A one-year-old girl in China was born with a fetus trapped inside her skull, doctors revealed in a new case report.
Neurosurgeons operated on the girl, who suffered from severe head swelling and developmental delays. But she died within a fortnight because the damage to her brain was too severe for her to survive.
This extremely rare condition, scientifically known as fetus-in-fetus, affects approximately 1 in every 500,000 birthsOnly 18 cases of this type of phenomenon inside the skull have been reported.
The one-year-old girl underwent surgery and had part of her skull removed so doctors could cut out the tissue.
After the brain tissue was removed, the patient never recovered and suffered a series of severe seizures. Images show her brain after surgery
Doctors still don’t understand what causes it, but they do know that it occurs during development inside the womb, when identical twins, which form when two eggs divide, don’t separate completely.
One twin then becomes trapped inside the other and may continue to develop features such as nails, hair, and limbs.
In 80 percent of cases, the absorbed fetal tissue lodges in the abdomen, where doctors have a high probability of removing it without harming the patient. In other cases, it has been identified in the child’s mouth, scrotum or tailbone.
For example, in 2015, Chinese doctors successfully removed a fetus found in the scrotum of a 20-day-old baby.
BBut the condition is nearly 100 percent fatal when it occurs in the head, Xuewei Qin and Xuanling Chen, study authors and anesthesiologists at Peking University International Hospital in Beijing, China, wrote in the article. American Journal of Case Reports.
The report states that during a routine check-up at 33 weeks, doctors discovered some “abnormalities” in the developing embryo’s skull.
But her delivery was quite normal: doctors delivered her by Caesarean section at 37 weeks. Her head was larger than normal, but she returned home with her mother from the hospital.
A year later, he was admitted to Peking University International Hospital because his head was swollen and not developing normally.
She was incontinent and had trouble standing, lifting her head, and uttering any word other than “Mama.”
So the doctors did a CT scan of his head and… The analysis revealed a 13cm-diameter mass in his skull, barely larger than a baseball. Inside the mass were large pieces of bone.
This scan taken before the tissue was removed shows the immature bones that the fetus contained within the child’s skull. The white arrow on the scan points to them.
The tissue removed from the skull was about 7 inches (18 cm) long, but when compressed into the skull it was about 5 inches (13 cm) in diameter.
At that point, doctors decided to operate to try to remove the mass. They put the girl to sleep and performed a craniotomy, removing part of the skull.
Inside they found a white capsule, which contained a thick brown liquid and an immature embryo.
The fetus had a spine and bones, and the beginnings of a mouth, eyes, hair, forearms, hands and feet. It was 18 centimetres long.
This caused “severe compression of brain tissue.” The patient never woke up and was on a ventilator while suffering from seizures after the operation.
Twelve days after surgery, the family decided to take her off life support.
The cause of these malformations “remains a mystery,” the study’s authors write, but could be related to environmental pollution, genetics, low temperatures, exposure to pesticides during pregnancy or problems with the division of eggs.