Diprosopus tetraophthalmus: CT as a complement to autopsy

Abstract

ABSTRACT. Diprosopus is the rarest form of conjoined twinning. This anomaly is characterised by craniofacial duplication to varying degrees and is associated with anomalies of the central nervous, cardiac, respiratory and musculoskeletal systems. We present an infant characterised as diprosopus tetraophthalmus who underwent postmortem CT, which served as a highly useful complement to autopsy.

Diprosopus: A Rare Conjoined Twin

“…1,3 In our case, there was anencephaly with cystic adenomatoid lesion in lung. These malformations can be diagnosed antenatally by sonography.…”

“…A commonly cited proposed etiology of diprosopus phenotype is rostral bifurcation or forking of notochord, which delineated the embryonic axis and induces neurulation. 1 Diprosopus is primarily found in singleton pregnancies but can also be seen in dichorionic twins. 4 Duplication of eyes is always associated with duplication of nose but nasal duplication can be isolated.…”

“…4 Duplication of eyes is always associated with duplication of nose but nasal duplication can be isolated. 1 In contrast to all other forms of conjoined twins which always have two complete notochoral axes, diprosopus might represent a genuine rostral bifurcation or duplication of the notochord. Alternatively diprosopus could be closely related to dicephalus, in which there are two completely separate but parallel notochoral axes within one vertebral column.…”

“…Computed tomography, magnetic resonance imaging and MR angiography are allowed study to know the duplicative changes in diprosopus, especially for planning of cosmetic correlation. 1 Usually, these fetuses are stillborn. Known instances of human with diprosopus surviving for longer than minutes to hours in the past is very rare.…”

Diprosopus twin

“…It often occurs in combination with other congenital disorders, particularly anencephaly, neural tube defect and cardiac malformations 5 . When present, the brain may show abnormalities ranging from partial to complete duplication of brain structures, and under development of brain tissues.…”