Gangopadhyay et al. Journal of Medical Case Reports 2010, 4:96 http://www.jmedicalcasereports.com/content/4/1/96 Page 6 of 7 Figure 6 Plain X-ray of the fetal specimen with a vertebral column. radiological and serological (AFP) follow-up [6]. Despite the AFP levels before and after surgery remaining at normal values, a possible recurrence of a malignant tera- toma after FIF resection must best be kept in mind. This was the reason why we continued to monitor the serial tumor marker levels of our patient, while also conducting cross-sectional imaging follow-up examina- tions [1]. Conclusion Alhtough it is rarely the conclusive diagnosis, FIF should still be considered in a child presenting with progres- sively increasing abdominal swelling and vomiting. Although definitive diagnosis is best made using CT and MRI techniques, plain X-rays and ultrasonography can still be useful in the initial work-up prior to surgery. Post-operative X-ray examination of a specimen from the mass can ultimately confirm the diagnosis of FIF. The mass, however, should still be examined for the occurrence of multiple fetus even after it has already been excised. Consent Written informed consent was obtained from the par- ents of our patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.` Author details 1Department of Pediatric Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. 2Department of Radiodiagnosis, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. Authors’ contributions ANG, SPS and PS operated on our patient and reviewed the literature. DKG and VK were the main moderators of the manuscript. All authors read and approved the final manuscript. Competing interests The authors declare that they have no competing interests. Received: 22 October 2009 Accepted: 25 March 2010 Published: 25 March 2010 References 1. Hoeffel CC, Nguyen KQ, Phan HT, Truong NH, Nguyen TS, Tran TT, Fornes P: Fetus in fetu: a case report and literature review. Pediatrics 2000, 105:1335-1344. 2. Patankar T, Fatterpekar GM, Prasad S, Maniyar A, Mukherji SK: Fetus in fetu: CT appearance–report of two cases. Radiology 2000, 214:735-737. 3. Magnus KG, Millar AJ, Sinclair-Smith CC, Rode H: Intrahepatic fetus-in-fetu: a case report and review of the literature. J Pediatr Surg 1999, 34:1861-1864. 4. Senyüz OF, Rizalar R, Celayir S, Oz F: Fetus in fetu or giant epignathus protruding from the mouth. J Pediatr Surg 1992, 27:1493-1495. 5. Willis RA: The borderland of embryology and pathology. Washington, DC: Butterworths, 2 1962, 442-462. 6. Hopkin KL, Dickson PK, Ball TI, Ricketts RR, O’Shea PA, Abramovosky CR: Fetus in fetu with malignant recurrence. J Pediatr Surg 1997, 32:1476-1479. 7. Kakizoe T, Tahara M: Fetus in fetu located in the scrotal sac of a newborn infant: a case report. J Urol 1972, 107:506-508. 8. Thakral CL, Maji DC, Sajwani MJ: Fetus in fetu: a case report and review of literature. J Pediatr Surg 1998, 33:1432-1434.