Emmeline Elaine L Cua, Esther A Saguil and Juanito S Javier
University of the Philippines-Philippine General Hospital, Philippines
Posters & Accepted Abstracts: J Leuk
Conjoined twins are rare phenomenon that occurs during monochorionic-monoamniotic twin gestation; when the embryo divides at 13-15 days after conception and the resulting pair does not fully separate. They may be classified as either symmetric or asymmetric, depending on the extent of development of each embryo. The latter case, which is also known as parasitic or heteropagus twinning occurs when one of the twins fails to undergo normal development and becomes vestigial and dependent on the other. The underdeveloped twin is referred to as the parasite, while the fully developed host is referred to as the autosite. This form of twinning occurs in 10% of conjoined twins, once in every 1 to 2 million live births. A rare case of parasitic twinning is reported. Comprehensive discussion on the radiologic workup consisting of whole body CT scan, pelvic CT angiography, craniospinal MRI, four-vessel cerebral angiography and contrast enema was performed to evaluate the patient's anatomy. Our case is unique as it presents a surgical dilemma as to which pair of extremities to remove based on anatomic versus functional status.