WARNING – GRAPHIC IMAGES: The little toddler was taken to hospital in Afghanistan with a swollen stomach that was thought to be a tumour – but doctors were stunned to find out the truth
A two-month-old baby shocked doctors after they discovered the foetus of a twin inside him. The young boy was admitted to the hospital with “abdominal swelling and a palpable mass” measuring 8x12cm on his stomach.
Doctors initially suspected a Wilms tumour or neuroblastoma as potential underlying causes – both of which typically present as large abdominal masses closely related to the kidneys – but were stunned to discover the real cause behind his discomfort. A contrast-enhanced abdomen CT scan found a ‘lesion’ with soft tissue, fat, fluid and bone components – with an apparent spine, ribs, facial bones and lower limbs.
READ MORE: NHS surgeons who separated conjoined twins 40 years ago emotionally meet one surviving twin
Under general anaesthesia, the toddler underwent surgery to remove the mass, which doctors found was contained within a membranous sac, supplied by major vessels from the aorta. They were able to successfully separate it from the boy and, upon opening the sac, doctors found an “incompletely formed foetus”.
The foetus was found to have a head of hair, well-developed spine, upper limbs with fingers, and lower limbs with feet and toes. The case is an example of ‘fetus in fetu’ – a rare congenital anomaly which occurs when the vertebrate foetus develops inside the body of its twin sibling.
There are fewer than 200 cases reported to date. The baby was treated in Kabul, Afghanistan, with a review of the case having been shared in a medical journal late last year.
The baby is believed to be recovering well with no further known issues at the time of writing. Elsewhere, two surgeons who led the separation of conjoined twins four decades ago in the UK have been in touch to celebrate their 40th birthday.
Both girls had been born facing each other – joined from breastbone to navel – and were given the names Holly and Carly. Just a few days later the team at Great Ormond Street Hospital in London, led by surgeons Lewis Spitz and Edward Kiely, carried out a nine-hour operation to separate them.
Despite the success of the separation, Carly died of heart complications around six weeks later. But Holly Queiroz, who now lives in Texas, has remained in touch with Prof Spitz including visiting London for his retirement party in 2004.
Before her 40th birthday she was reunited on a Zoom call with him and Mr Kiely, who she had not seen for two decades. Holly said: “I wanted to say thank you to them both, I truly am alive because of them and I know it was a whole different world 40 years ago,
“And things were quite new in this realm, but God bless them for having the knowledge and the ability. I am so thankful for them both because I have been able to live a really beautiful life and it wouldn’t have happened without them.”
Holly’s mum Jill Reich underwent a Caesarean section in 1985 and was told the news she had given birth to conjoined twins. Her parents were from America and the twins were brought to Great Ormond Street Hospital on the day they were born.
Holly went on to have 10 surgeries in the following months and remained at GOSH for almost a year. During this time her dad had to keep returning to America for work and Holly’s mum remained in the UK looking after her and her then-three-year-old sister. Teams at Great Ormond Street Hospital have since operated on 43 sets of conjoined twins – thought to be the most in the world at a single hospital.
