[Diprosopus triophthalmus. From ancient terracotta sculptures to spiral computer tomographic reconstruction]

Abstract

A still-born male fetus from the 19th century, fixed in formalin and presenting as diprosopia triophthalmica, was analysed by helical computer tomography and virtually reconstructed without damage. This rare, incomplete, symmetrical duplication of the face on a single head with three eyes, two noses and two mouths develops in the first 3 weeks of gestation and is a subset of the category of conjoined twins with unknown underlying etiology. Spiral computer tomography of fixed tissue demonstrated in the more than 100 year old specimen that virtual reconstruction can be performed in nearly the same way as in patients (contrast medium application not possible). The radiological reconstruction of the Munich fetus, here confined to head and neck data, is the basis for comparison with a number of imaging procedures of the last 3000 years. Starting with some Neolithic Mesoamerican ceramics, the "Pretty Ladies of Tlatilco", diprosopia triophthalmica was also depicted on engravings of the 16th and 17th century A.D. by artists as well as by the anatomist Soemmering and his engraver Berndt in the 18th century. Our modern spiral computer tomography confirms the ability of our ancestors to depict diprosopia triophthalmica in paintings and sculptures with a high level of natural precision.