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This is a 30 year old female who presented to the ultrasound unit at a gestational age of 18.5 menstrual weeks with diamniotic, dichorionic twins. Her past history was remarkable for a prior fetus with Turner's syndrome. The initial study indication was for fetal growth evaluation and the anatomic survey for both twins was unremarkable. She had a repeat scan for growth evaluation at 25.3 menstrual weeks. At that time, one of the twins demonstrated bilateral pleural effusions (Figures 1 and 2). The right lung appeared to be replaced by an echogenic complex mass that measured 4.2 x 4.4 x 2.5 cm. Several fluid-filled cysts (about 2-3 mm size) were present throughout the mass. Doppler ultrasonography did not suggest unusual vascularity.
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