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Case Reports in Pediatrics
Volume 2012, Article ID 831649, 4 pages
Case Report

A Rare Form of Heteropagus Twinning: Three-Armed Infant with Spinal Dysraphism

1Radiology Department, Sifa University, Izmir, Turkey
2Department of Pediatrics, Sifa University, Izmir, Turkey
3Department of Pediatrics, Dokuz Eylul University, Izmir, Turkey

Received 3 November 2012; Accepted 26 November 2012

Academic Editors: J. Kobr and I. Riaño Galán

Copyright © 2012 Aynur Solak et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


An ectopic or accessory limb attached to the back is an extremely rare and strange condition, and there are only a few documented cases in the worldwide literature. The first case was described by Jones and Larkin (1889). There are several theories regarding the origin of this condition. Asymmetric conjoined twinning which is located dorsally in the vertebral column (rachipagus) is the most probable diagnosis of our patient. Conjoined twinning is very rare and the incidence is 1 per 50 000 live births. Rachipagus is even rarer, with no more than 30 case reports so far (Chadha et al. (1993, 2006)). In this report, we present a patient who underwent successful surgical excision of a third arm attached to the back in the midline over the low-dorsal region. Differential diagnoses including teratoma and fetus in fetu are discussed.