{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T08:04:34Z","timestamp":1753862674245,"version":"3.41.2"},"reference-count":59,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Externally attached supra\u2010numerary body structures are a rare congenital malformation. Dysmorphogenesis remains controversial, hence many different classifications have been proposed over the years. We report a case of a supra\u2010numerary lower limb grafted onto a sacrococcygeal mass in a child with a myelomeningocele. Prevailing theories for its origin are revised as well as prenatal and postnatal management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case<\/jats:title><jats:p>The case relates to a female neonate with a third lower limb grafted to a lumbosacral mass found upon birth. Postnatal imaging revealed a lipomyelomeningocele and a supra\u2010numerary limb. Surgical intervention was performed on day seven of life with removal of the supra\u2010numerary limb and correction of the dural defect. Anatomopathologic study revealed mature and dysplastic tissues of the three germlines. The infant was discharged after 16\u2009days to follow\u2010up by a multidisciplinary team. In early follow\u2010up, minor asymmetry in lower limb mobility, peri\u2010anal anesthesia, and bladder incontinence was present. Currently 8\u2009years old, the patient has no motor or sensory dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This case challenges the existing theories for conjoined twinning, as they do not fully explain the co\u2010occurrence of neural tube defects in sacrally fused supra\u2010numerary structures. Whether these malformations are entities of a single disease spectrum or the result of independent dysmorphogenesis is debated. Prenatal diagnosis with sequential investigation of morphogenesis as well as postnatal anatomopathological examination are crucial for a better understanding of complex biologic processes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdr2.2447","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T12:05:21Z","timestamp":1738670721000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Supra\u2010Numerary Limb Grafted Onto a Sacrococcygeal Mass in a Child With Spinal Dysraphism: Case Report, Dysmorphogenesis, and Management Review"],"prefix":"10.1002","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4266-7431","authenticated-orcid":false,"given":"Kaylene","family":"Freitas","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Pediatria, Hospital Dr. N\u00e9lio Mendon\u00e7a, Centro Hospitalar do Funchal  Funchal Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonor","family":"Castro","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Medicina Intensiva Neonatal e Pedi\u00e1trica (SMINP), Hospital Dr. N\u00e9lio Mendon\u00e7a, Centro Hospitalar do Funchal  Funchal Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carla","family":"Pilar","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Cirurgia Pedi\u00e1trica, Hospital Dr. N\u00e9lio Mendon\u00e7a, Centro Hospitalar do Funchal  Funchal Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catarina","family":"Barreira","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Neurocirurgia, Hospital Dr. N\u00e9lio Mendon\u00e7a, Centro Hospitalar do Funchal  Funchal Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosete","family":"Nogueira","sequence":"additional","affiliation":[{"name":"Medicine School and ICVS, ICVS\/3B's PT Government Associate Laboratory Minho University  Braga Portugal"},{"name":"LAP, UPPEF, CGC Genetics, Unilabs  Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Medicina Intensiva Neonatal e Pedi\u00e1trica (SMINP), Hospital Dr. N\u00e9lio Mendon\u00e7a, Centro Hospitalar do Funchal  Funchal Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,2,4]]},"reference":[{"volume-title":"StatPearls [Internet]","year":"2023","author":"Adigun O. 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