Bilateral Fetal Hexadactyly Combined with Transient Dacryocystocele

Introduction

Fetal polydactyly/hexadactyly, a supernumerary or rudimentary finger present on one or either fetal hands or feet, could be a sign of an underlying chromosomal aberration like trisomy 18 or 13, so in cases when hexadactyly is detected prenatal karyotyping is recommended. A supernumerary finger could be located on either side of the hand (radial or ulnar) or somewhere in between. Furthermore, it is also part of other malformation syndromes, like Meckel-Gruber or Ellis-van-Creveld syndrome. However, hexadactyly could be an isolated anomaly found prenatally in fetuses with a normal karyotype and with no other additional anomalies, and is even inheritable in some families. The manner of postnatal treatment of hexadactyly depends on how developed this supernumerary finger is.

Dacryocystocele is a rare condition that could be detected prenatally mostly during the third trimester of gestation. It is a fluid-filled structure caused by obstruction of the lacrimal drainage system and could be easily visualized by 2 D ultrasound as an anechoic cystic structure positioned inferior and medial to the orbit. Three-dimensional (3 D) multiplanar and surface views facilitate prenatal diagnosis. In many cases dacryocystocele resolves spontaneously, even prenatally, but mostly in the early neonatal period (Sharony R et al. Ultrasound Obstet Gynecol 1999; 14: 71 – 73 and Sepulveda W et al. J Ultrasound Med 2005; 24: 225 – 230).