Fetiform Teratoma (Homunculus) Coexist with Intrauterine Foetus: A Case Report

Abstract

Fetiform teratoma is also known as a homunculus, a rare form of mature cystic teratoma with a good prognosis. We report a case of fetiform teratoma that coexist with a female neonate in a 27-year-old woman. She presented with 2 days history of abdominal pain and generalized body weakness of 3 days at 38 weeks gestation. On clinical examination, gravid enlarged uterus with twin foetus palpated on a transverse lie and imminent foetal distress. Emergency Ultrasound done showed twin gestation at 39 weeks +5 days. The patient underwent an emergency caesarean section delivered of a female baby with a foetus like mass attached to the palate of the live female baby by a stalk. The clinical diagnosis of parasitic twin gestation was made and the mass was sent for histopathological analysis. On gross examination, a skin bearing mass with 2 limbs buds reminiscent of homunculus without demonstrable vertebrae or bony tissue on cross-section. Histopathology analysis showed tumour tissue composed of haphazard arrangement mature tissue comprising derivative from ectoderm namely skin tissue, sebaceous gland, hair follicle, mesodermal derivative are cartilage and adipose tissue. Endodermal differentiation is intestinal glands lined by columnar epithelial cells admixed with goblets cells. In summary, a diagnosis of fetiform teratoma was made and the baby that coexisted with the mass was adequately follow-up without any complications.