In the case of single fetal demise in a twin gestation, the fate of the dead twin, surviving twin, and mother depend on the exact time of fetal demise. The dead twin may "vanish" in a first trimester death; form a mummified "fetus papyraceus" due to mechanical compression in the second trimester or show changes of maceration in the third trimester. Hematological complications in the mother and neurological complications in the surviving twin may ensue in later trimester deaths. We report a unique case of an undiagnosed fetus papyraceus incidentally detected in an otherwise normal placenta. Identification of such cases is essential due to the occurrence of severe complications in some of the cases, medicolegal implications for the caregivers, and to improve the understanding of embryological development and fetal demise in twin or multiple gestations.
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