Duplicata incompleta with caudal regression syndrome

Othman A. R. M. Al-Asali, MD., Amal Taha, MD.

Al-Hammadi Hospital, Riyadh, Saudi Arabia.

Case report

This is a case of a 36-year-old G1 P0 who was treated for infertility for the past 16 years. This was her first pregnancy after in vitro-fertilization. It was a twin pregnancy after a transfer of two embryos.
Patient went into a preterm labor and delivered at 31 weeks of gestation. The first baby was a healthy boy of 1800 grams with Apgar scores 6/7/7 (1st/5th/10th minute).
The second baby had multiple malformations. The head showed signs of duplication with 2 pairs of eyes, double chin, wide mouth. The lower extremities were malformed with caudal regression syndrome. Our final diagnosis based on the clinical findings was duplicata incompleta; monocephalus diprosopus tetraophtalmos (“Diprosopus” means “two-faced” in Greek), so called monocephalic diprosopus.Images 1,2: Image 1 shows the face, eyes and mouth (arrow). Image 2 shows an axial view of the head.

 

Images 3,4: Image 3 shows a parasagittal view of the spine, head is on the right. Image 4 shows the femur bone.

Images 5,6: Axial view of the all 4 eyes (*).     

Images 7,8: Images of the 2nd twin after delivery, note the malformed head with 4 eyes, double chin, wide mouth, no apparent nose.

Images 9,10: Note malformed lower extremitites resmbling caudal regression syndrome.