case_images: PMC3307243_01
case_images: Demonstration of facial abnormalities (a) full body view showing scoliosis, frontal view demonstrating hypertelorism and cleft lip and image of mouth showing supernumerary teeth (b) demonstration of independent movement of double tongues: right tongue withdrawn while left protrudes
case_images: SNI-3-23-g001.jpg
case_images: PMC3307243_01_SNI-3-23-g001.jpg
case_images: F1
case_images: Facial abnormalities include turribrachycephaly, flattened midface, hypertelorism, cleft palate, bilateral cleft lower lip, supernumerary teeth, macrostomia, short neck with limited range of movement and two separate, fully formed, independently moving tongues - double tongue [Figure 1a].
case_images: PMC3307243_02
case_images: T1 weighted MRI with contrast (a) axial image of duplicate pituitary gland (b) coronal image of duplicate pituitary gland (c) coronal image demonstrating two widely spaced pituitary stalks
case_images: SNI-3-23-g002.jpg
case_images: PMC3307243_02_SNI-3-23-g002.jpg
case_images: F2
case_images: Head MRI reveals duplication of multiple midline structures: two sellas and two pituitary glands, a duplicate ventricular system, two basilar arteries and a midline third cerebral peduncle [Figures 2a-c and 3a, b].
case_images: T1 weighted MRI with contrast of associated cranial abnormalities (a) axial image of midline third cerebral peduncle (b) coronal image demonstrating fenestration of basilar artery, agenesis of corpus callosum
case_images: SNI-3-23-g003.jpg
case_images: PMC3307243_02_SNI-3-23-g003.jpg
case_images: F3
case_images: Head MRI reveals duplication of multiple midline structures: two sellas and two pituitary glands, a duplicate ventricular system, two basilar arteries and a midline third cerebral peduncle [Figures 2a-c and 3a, b]. Her imaging is also notable for agenesis of the corpus callosum and a clival encephalocele Figure 3 with an adjacent midline nasopharyngeal tumor consistent with residual teratoma [Figure 4].
case_images: Midline saggital T1 weighted MRI with contrast: defect in the clivus is observed with accompanying encephalocele. Naso-pharyngeal teratoma also observed
case_images: SNI-3-23-g004.jpg
case_images: PMC3307243_02_SNI-3-23-g004.jpg
case_images: F4
case_images: Her imaging is also notable for agenesis of the corpus callosum and a clival encephalocele Figure 3 with an adjacent midline nasopharyngeal tumor consistent with residual teratoma [Figure 4].
case_images: Coronal T1 weighted MRI with contrast: odontoid process and vertebral body duplication
case_images: SNI-3-23-g005.jpg
case_images: PMC3307243_02_SNI-3-23-g005.jpg
case_images: F5
case_images: The craniocervical junction appeared abnormal with a widened C1 arch, C2 body duplication and two odontoid processes [Figure 5].