Tail-like Congenital Duplication of Lower Extremity (Extra Leg or Vestigial Parasitic Twin)

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Temesgen Mekonnen


BACKGROUND: Congenital duplication of lower extremity, eithercomplete or incomplete is extremely rare. Only 26 cases had beenreported till 2010, of which only 5 cases had feature of completeduplication. Theories have been proposed that the cause of thisabnormality includes maternal factors like diabetes and usage ofteratogenic drugs. Duplication of lower extremity may mimic thatof vestigial parasitic twin; phenotypically, it appears as anindividual with extra appendage or limbs. Vestigial parasitic twisare very rare comprising only 10% of all conjoined twins).Conjoined twin by itself is rare because the survival rate after birthis approximately 25%.CASE DETAILS: A 5-year old female patient came from a ruralarea of Ethiopia was referred to our hospital for radiologicaldiagnosis and to assess the vascular supply. No family history ofsimilar congenital abnormality was identified. No known history ofchronic illness or maternal usage of teratogenic drugs wasidentified either.CONCLUSION:A child with parasitic twin and completeduplication of lower limb is reported .Tail-like soft tissue was foundarising from sacral area. CT scan findings confirmed theduplication of the lower limb bones. Fatty tissue was the majorcomponent of the soft tissue almost replacing themuscle.Reconstructed CT angiography images showed majorarterial blood supply of the parasite limb. Surgical intervention wasdone successfully.This type of case is unusual. It is the rarest typeof lower limb duplication.


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Temesgen Mekonnen, Addis Ababa,Ethiopia

Department of Radiology and
Imaging, Myungsung Christian
General Teaching Hospital and Medical Collage,