The Foot At The Wrong End

Performing an operation on October 3, 2008, Dr. Paul Grabb was surprised to find a foot inside a newborn baby's brain. The brain surgeon also discovered what seemed to be coils of an intestine, as well as a developing hand, thigh and an additional foot — all of which endangered the child's life.

To the Colorado Springs Gazette, Dr. Grabb described the situation as being like a breach delivery of an infant but "coming out of the brain."

On October 1, the baby, Sam Esquivel, had been delivered by C-section because of a tumor developing in his brain, which had been detected by an MRI scan. His parents Tiffnie and Manuel Esquibel, had merely expected that the birth would have to be induced because of Tiffnie's 41-week pregnancy, but not the emergency that occurred. Days after Sam's birth, Dr. Grabb conducted the brain operation at Colorado Springs' Memorial Hospital for Children to remove what was guessed to be a teratoma, a tumor which can be full of hair, muscle or teeth. Teratomas do not usually contain the complex body parts found in Sam. Pediatric surgeons worldwide, when shown pictures, never saw the like. Dr. Grabb noted the situation as "completely abnormal."

Teratomas are often discovered in adulthood, as benign tumors. A fetal twin growing within a fetus (fetus in fetu) is far rarer than a normal teratoma, and only about 10 of the 90 officially reported have been in the brain.

The operation succeeded, with Sam doing well enough neurologically. One side of the infant's body is weak, and some eye functions are not ideal. Rehabilitation is underway, and occupational therapist Jeanine Noll reports good progress. Since the tumor can return, the child will be monitored on a regular basis.

Tiffnie Esquibel, Sam's mother, commented to TheDenverChannel on December 17 that she did not want her baby's face exposed publicly, for fear of him being thought a freak. The baby had come far in recovery from the surgery, with only a small scar remaining — a detail revealed in released photographs that did not show his very normal face.

Grabb says the case raises questions about how the body forms its extremities. Could an organ or an extremity be grown for patients who need them? If so, new possibilities for treatment would result.

— Douglas Chapman


Deseret News,,5143,705271535,00.html, 12/19/08

The (ABC 7 News),, 12/17/08 (from Associated Press),, 12/18/08

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