A Colorado Springs family is part of one of the strangest cases in medical history.Dr. Paul Grabb, a pediatric brain surgeon, said he was surprised when he discovered a small foot growing inside the brain of 3-day-old Sam Esquibel."The foot literally popped out of the brain," Grabb told TheDenverChannel Wednesday.The appendage threatened the newborn's life.When Grabb performed the life-saving surgery at Memorial Hospital for Children in Colorado Springs, he was in for another surprise: he also found what appeared to be parts of an intestine in the folds of the infant's tiny brain, in addition to another developing foot, hand and thigh.
Click here for a photo of the foot.Warning: graphic content.
"I've never seen anything like it before," Grabb told the Colorado Springs Gazette. "It looked like the breach delivery of a baby coming out of the brain."Sam was delivered on Oct. 1, within hours of an ultrasound that showed what appeared to be a tumor developing in the brain of the fetus. Three days later, Grabb performed the surgery to remove it.The reason for the strange growth was not clear at first. It was thought to be a teratoma -- a congenital brain tumor composed of foreign tissue such as muscle, hair or teeth -- or a fetus in fetu, which is a developmental abnormality in which a fetal twin begins to form within the other.Grabb, the only pediatric brain surgeon in southern Colorado, said that the formal pathology report identified the mass as a teratoma because of how perfectly formed the structure was but there is a fine line between that and the fetus in fetu."So it's unclear if a fetal twin began to form within another," Grabb said.Grabb said he sees a teratoma once every few years but it doesn't compare to Sam's. Teratoma tumors do not usually grow as complex as a foot."You show those pictures to the most experienced pediatric neurosurgeons in the world, and they've never seen anything like it," Grabb told the Gazette. "This is completely abnormal."Grabb said neurologically, Sam is expected to do well. Sam's brain tumor can come back so he will be monitoring that in the months and years to come.
Mom Says Baby A Miracle
Sam's mom, Tiffnie, told TheDenverChannel on Wednesday that her son is doing well but that she didn't want to appear on camera because she doesn't want to exploit her child and make him appear like a freak in the eyes of the world."This is our baby," Tiffnie explained, in tears.She said when she first talked to the Gazette, she thought the story would only appear in the small-town paper. But it has circled the globe and she is getting calls from national and international media outlets."I am so overwhelmed right now ... We've been bombarded with calls," Tiffnie said.DenverChannel.com Reporter Jane Slater held the infant with the baby blue eyes and round face and said "he is the cutest baby I've ever seen." Sam's at a healthy weight -- as evidenced by his pudgy arms and legs -- which explains why family members call him the "Michelin Man," Slater said.He was alert and happy, with a barely visible inch-long scar which stretched from his hairline to the top of his cheek.Sam is still recovering from the surgery and shows weakness on one side of his body and some trouble with higher-level eye functions. He is already undergoing rehabilitation.Tiffnie had said that her pregnancy was easy and there were no signs of complications until the ultrasound on Oct. 1. She and her husband had given up on the idea of having any children after years of trying and then Sam was conceived. Tiffnie said she doesn't mind driving to the hospital every week or month for Sam's MRI and blood checks, considering that he is healthy and happy."It's a miracle," she said.In the meantime, Grabb wonders about the possibilities for medical science."How does the body form complete extremities? Who is to say we can't grow a heart, leg or foot?" Grabb asked the Denver Post earlier. "This could show a window of what's possible.""It's always impressive to see these sorts of things but it's not as unsual as you would think," said Dr. Rich Gustafson, with Cherry Creek Pediatrics. "Teratomas can be found in abdomens or other parts of the body ... what made this case so unusual is how perfectly formed the foot was and being in the skull as well. Usually, it's a totally safe and benign tumor. Often, it gets picked up in adulthood but now with ultrasound, you're actually picking more up as they are getting fetal ultrasounds."