Gangopadhyay et al. Journal of Medical Case Reports 2010, 4:96 http://www.jmedicalcasereports.com/content/4/1/96 Page 4 of 7 Figure 3 A 64-slice computed tomography scan of the bony outline of the fetus in fetu. effect of the mass, such as abdominal distension, feeding difficulties, emesis, jaundice and dyspnea [2,11]. In our case, our patient presented with distension of the abdo- men and recurrent vomiting. The pre-operative diagnosis of FIF depends on its related radiological findings. Plain abdominal X-ray examination may prove helpful, as up to half of reported cases show the presence of a vertebral column and axial skeleton [1], which was also the case for our patient. Meanwhile, Hoeffel et al. [1] discussed the inability of radiographic examination to visualize the vertebral axis of the FIF. This inability to visualize the vertebral axis when a patient is examined through a CT scan, how- ever, should not lead to diagnostic exclusion because an under-developed and markedly dysplastic spinal column may have prevented identification of the pathology at imaging. Sonographic findings are usually those of a complex cystic mass with ill-defined solid internal components. Imaging continues to play an important role in diagnos- ing FIF. CT and MRI have been proven to be very help- ful in suggesting a pre-operative diagnosis [11]. In our