Maria Carolina CantareroPediatric Neurosurgeon and Epilepsy, Nicaragua
Title: The first case of fetus in fetu in nicaragua: The management experience of the Pediatric Neurosurgery Team
Fetus in fetu (FIF) is a rare congenital anomaly of asymmetric monozygotic twins, where the parasitic twin develops abnormally inside the body of the host twin. In most cases, it is incorporated into the sibling’s abdomen, which frequently presents as a retroperitoneal mass. Currently, at least 200 cases have registered worldwide, being this the first case in Nicaragua. We describe a case of a male newborn, born via cesarean section, with a history of multiple congenital malformations observed via ultrasound examination. At birth, a mass is observed on its dorsum that impresses a skull, but without the presence of bones, with three limbs, two upper and one lower, with an outline located transversely on the pelvic girdle and the presence of two male genitalia with agenesis of the testicles and an accessory kidney. A preoperative diagnosis of FIF and spinal dysraphism was made by computed tomography (CT) and magnetic resonance imaging (MRI). They shared a spinal cord and had the presence of an open spinal defect type meningocele with aberrant roots. After the diagnosis and discussion, the multidisciplinary team proceeded to surgery to perform the separation of the twin (FIF). The subsequent anatomo pathological examination revealed that the fetus was anencephalic and had reliable FIF characteristics. The resection was performed followed by the closure of the 430 mL meningocele and complete separation of the spine and the parasitic twin. We present the first case of fetus in fetu in Nicaragua and patient evolution up to the present.
Carolina Cantarero is the first woman to become a neurosurgeon in Nicaragua in 2006 at the National Autonomous University of Nicaragua and is the first professional to become a pediatric neurosurgeon in her country. She graduated from The Federico Gomez children´s Hospital in Mexico of pediatric neurosurgeon and neurosurgery of epilepsy. She currently head of the neurosurgery service at the national referral Hospital Manuel de Jesus Rivera in Nicaragua and Member of the maternal fetal unit and fetal surgery of Nicaragua.
She performs around 250 surgeries on children per year throughout the country.