A parasitic (or asymmetrical conjoined) twin is an embryonic anomaly that primarily affects males. It involves a rare twin malformation where tissue matter that should make up a second fetus grows within the body of the more normally-developed host twin. The solution to such cases is to surgically excise the components of the “parasitic twin” in order to ensure the most normal possible growth for the surviving one.
While the phenomenon has become increasingly rare in developed countries thanks to the possibility of prenatal diagnoses, it still arises – often with unfavorable outcomes – in limited-resource countries, due to both the absence of prenatal screening programs and the lack of means for managing such cases.
The case presented here is the first ever recorded in Mozambique, and one of the rare ones in sub-Saharan Africa to have a favorable outcome. A multidisciplinary team performed a successful surgical operation to remove two supernumerary lower limbs and seven months later, the surviving infant girl is developing normally.
We deem this experience a success based not only on the positive outcome of the surgical procedure, but also the fact that we were able to manage such a rare and complicated case in a setting where the possibility of prenatal diagnosis, specialists and adequate equipment were all unavailable