Laryngotracheoesophageal Cleft and Unilateral Pulmonary Hypoplasia in Twins

Laryngotracheoesophageal cleft1 and unilateral hypoplasia of the lung2 are rare congenital anomalies which heretofore have not been considered related. We report a unique pair of monozygous twins with mirror-image unilateral pulmonary hypoplasia associated in one twin with an extensive laryngotracheoesophageal cleft. A review of previous reports and embryologic considerations suggest that this association is not unlikely. CASE REPORT Twin girls were delivered by cesarean section after a 35-week gestation of a gravida 10, 39-year-old woman. The pregnancy had been uneventful until the onset of premature labor. Six previous pregnancies had produced normal healthy children and three had ended in first trimester abortions. Examination of the twin placenta showed that it was diamnionic-monochorionic, implying that the twins were monozygotic.