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2012-01-22-06 Case of the week #316 © Bronshtein

Answer to the case of the week #316

April 12th, 2012 - April 26th, 2012 

Moshe Bronshtein, MD.

Haifa, Israel.

(Edited by Frantisek Grochal)

Case report

Following images and videos demonstrate an interesting anomaly of a 16-week-old fetus.

Our ultrasound examination revealed partial agenesis of the fetal sacrum in association with the presence of a pre-sacral anterior meningocele. No other fetal anomalies were found (including the brain and cerebellum).

During the scan similar anomaly was found in the mother. As her six year-old daughter suffers from obstipation the above mentioned maternal-fetal ultrasonographic findings prompt us to have them examined by the MRI.

The MRI revealed the same pathology of all of them - Currarino syndrome (Currarino triad). This anomaly is characterized by partial agenesis of the sacrum, presence of a mass in the presacral space in front of the sacrum (meningocele or teratoma), and malformations of the anus or rectum.

Images 1, 2: 16 weeks of gestational age; the images show sagittal scan of the fetal pelvis with hypoplastic sacrum - partial agenesis (depicted in red on the image 2) and presacral meningocele (depicted in blue on the image 2).


Images 3, 4, 5, 6, 7, 8, and 9: 16 weeks of gestational age; the images show several scans of the fetal pelvis with hypoplastic sacrum - partial agenesis, and presacral meningocele (marked by red asterisk on the images 4 and 6).



Images 10, 11, 12, and 13: MRI images; the images 10 and 11 show sagittal scan of the fetus with hypoplastic sacrum  and presacral meningocele (marked by red asterisk on the image 11); the images 12 and 13 show sagittal scan of the maternal sacrum with presacral meningocele (depicted in blue on the image 13) - maternal Currarino syndrome; the fetus is visible only partially on the left side.



Videos 1, 2: 16 weeks of gestational age; the videos show coronal (video 1) and sagittal (video 2) scans of the fetal sacrum - partial agenesis of the sacrum and presacral meningocele can be seen.


Video 3 and image 14: The video and image show ultrasonographic appearance of maternal pelvis obtained during the fetal examination during her 16 weeks of pregnancy. Dominant hypoechoic region represents maternal presacral meningocele, making a part of the Currarino syndrome (the same anomaly was found in the fetus).


Images 15, 16: The images represent sagittal MRI scan of the 6-year-old daughter of the above mentioned mother. She was suffering from obstipation and the MRI scan found similar partial agenesis of the sacrum with presacral meningocele (marked by red asterisk on the image 16) - the Currarino syndrome.

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