Lithopaedion

Lithopedion

Lithopedion

Calcified body of a dead fetus


A lithopedion (also spelled lithopaedion or lithopædion; from Ancient Greek: λίθος "stone" and Ancient Greek: παιδίον "small child, infant"), or stone baby, is a rare phenomenon which occurs most commonly when a fetus dies during an abdominal pregnancy,[1] is too large to be reabsorbed by the body, and calcifies on the outside as part of a foreign body reaction, shielding the mother's body from the dead tissue of the fetus and preventing infection.

Lithopedion, lacking facial features, with calcification of the placenta and soft tissues
A lithopedion. This highly unusual specimen remained in the abdomen of a woman for 2 years

Lithopedia may occur from 14 weeks gestation to full term. It is not unusual for a stone baby to remain undiagnosed for decades and to be found well after natural menopause; diagnosis often happens when the patient is examined for other conditions that require being subjected to an X-ray study. A review of 128 cases by T.S.P. Tien found that the mean age of women with lithopedia was 55 years at the time of diagnosis, with the oldest being 100 years old. The lithopedion was carried for an average of 22 years, and in several cases, the women became pregnant a second time and gave birth to children without incident. Nine of the reviewed cases had carried lithopedia for over 50 years before diagnosis.[2]

According to one report, there are only 300 known cases of lithopedia[3] recorded over 400 years of medical literature. While the chance of abdominal pregnancy is one in 11,000 pregnancies, only between 1.5 and 1.8 percent of these abdominal pregnancies may develop into lithopedia.[4]

History

A CT scan showing an extra-uterine calcified foetal skeleton, a lithopedion

The earliest known lithopedion was found in an archaeological excavation at Bering Sinkhole, on the Edwards Plateau in Kerr County, Texas, and dated to 1100 BC.[5] Another early example may have been found in a Gallo-Roman archaeological site in Costebelle, southern France, dating to the 4th century.[6]

The condition was first described in a treatise by the Spanish Muslim physician Abū al-Qāsim (Abulcasis) in the 10th century.[5] By the mid-18th century, a number of cases had been documented in humans, sheep and hares in France and Germany. In a speech before the French Académie Royale des Sciences in 1748, surgeon Sauveur François Morand used lithopedia both as evidence of the common nature of fetal development in viviparous and oviparous animals, and as an argument in favor of caesarean section.[7]

An archeological team did a "differential diagnosis of a calcified cyst found in an 18th century female burial site at St. Nicholas Church cemetery" in Czechia and determined the mass was likely either a case of lithopedion or fetus in fetu.[8]

In 1880, German physician Friedrich Küchenmeister reviewed 47 cases of lithopedia from the medical literature and distinguished three subgroups: Lithokelyphos ("Stone Sheath"), where calcification occurs on the placental membrane and not the fetus; Lithotecnon ("Stone Child") or "true" lithopedion, where the fetus itself is calcified after entering the abdominal cavity, following the rupture of the placental and ovarian membranes; and Lithokelyphopedion ("Stone Sheath [and] Child"), where both fetus and sac are calcified. Lithopedia can originate both as tubal and ovarian pregnancies, although tubal pregnancy cases are more common.[2]

Reported cases

Before 1900

More information Patient (age at time of diagnosis), Location ...
* After death of the patient.

After 1900

More information Patient (age at time of diagnosis), Location ...

See also


Notes

  1. Spitz, Werner U.; Spitz, Daniel J., eds. (2006). "Chapter III: Time of Death and Changes after Death. Part 1: Anatomical Considerations.". Spitz and Fisher's medicolegal investigation of death : guidelines for the application of pathology to crime investigation (4th ed.). Springfield, Ill.: Charles C. Thomas. pp. 87–127. ISBN 0398075441. OCLC 56614481.
  2. Bondeson, Jan (2000). The two-headed boy, and other medical marvels. Ithaca, NY: Cornell University Press. pp. 39–41. ISBN 0801437679. OCLC 43296582.
  3. Passini, Renato; Knobel, Roxana; Parpinelli, Mary Ângela; Pereira, Belmiro Gonçalves; Amaral, Eliana; de Castro Surita, Fernanda Garanhani; de Araújo Lett, Caio Rogério (November 2000). "Calcified abdominal pregnancy with eighteen years of evolution: case report". São Paulo Medical Journal. 118 (6): 192–94. doi:10.1590/S1516-31802000000600008. PMID 11120551.
  4. Mishra, JM; Behera, TK; Panda, BK; Sarangi, K (September 2007). "Twin lithopaedions: a rare entity" (PDF). Singapore Medical Journal. 48 (9): 866–68. PMID 17728971. Archived (PDF) from the original on 27 January 2018. Retrieved 14 February 2014.
  5. Rothschild, BM; Rothschild, C; Bernent, LG (July 1993). "Three-millennium antiquity of the lithokelyphos variety of lithopedion". American Journal of Obstetrics and Gynecology. 169 (1): 140–41. doi:10.1016/0002-9378(93)90148-c. PMID 8333440.
  6. Rose, Mark (January–February 1997). "Origins of Syphilis". Archaeology Magazine. Vol. 50, no. 1. Archived from the original on 24 December 2012. Retrieved 9 May 2023.
  7. Stofft, Henri (1986). "Un lithopédion en 1678" [One case of Lithopaedion in 1678] (PDF). Histoire des sciences médicales (in French). 20 (3): 267–286. PMID 11634084. Archived from the original (PDF) on 27 January 2018. Retrieved 9 May 2023.
  8. Kwiatkowska, Barbara; Bisiecka, Agata; Pawelec, Łukasz; Witek, Agnieszka; Witan, Joanna; Nowakowski, Dariusz; Konczewski, Paweł; Biel, Radosław; Król, Katarzyna; Martewicz, Katarzyna; Lissek, Petr; Vařeka, Pavel; Lipowicz, Anna (2 July 2021). "Differential diagnosis of a calcified cyst found in an 18th century female burial site at St. Nicholas Church cemetery (Libkovice, Czechia)". PLOS ONE. 16 (7): e0254173. Bibcode:2021PLoSO..1654173K. doi:10.1371/journal.pone.0254173. ISSN 1932-6203. PMC 8253445. PMID 34214114.
  9. Schumann, Edward A. (1921). Extra-uterine pregnancy. Gynecological and obstetrical monographs. New York: Appleton. LCCN 31005951. OCLC 951855728 via HathiTrust. Free access icon
  10. Félice, Fortuné Barthélemy de (1775). Encyclopédie, Ou Dictionnaire Universel Raisonné Des Connoissances Humaines. Vol. 3. Con–Impu via Google Books.
  11. Bondeson, Jan (2004). The Two-Headed Boy, and Other Medical Marvels. Ithaca, N.Y.: Cornell University Press. pp. 46–47. ISBN 978-0801489587. OCLC 56642689.
  12. Morand, S.F. (1748). "Histoire de l'Enfant de Joigny, qui a été treinte-un ans dans le ventre de sa mère; avec de remarques sur les phénoménes de cette espèce" [Story of the Child of Joigny, who was thirty-one years old in his mother's womb; with remarks on the phenomena of this species]. Histoire de l'Académie Royale des Sciences (in French). MDCCXLVIII. Académie des Sciences: 108–122 via Gallica (Bibliothèque Nationale de France). Free access icon
  13. Bjerke, Ernst (13 December 2007). "Et "tiaarigt Svangerskab"" [A pregnancy of 10-years duration] (PDF). Tidsskr Nor Laegeforen (in Norwegian). 127 (24): 3249–3253. PMID 18084382. Citing Otto Christian Stengel's "Udfaldet af et tiaarigt Svangerskab" in Eyr, Vol. 2, 1827, pp. 134–37, et al.
  14. Bernard, Grace Parkhurst (1947). "Lithopedion from the Case of Dr. William H. H. Parkhurst, 1853". Bulletin of the History of Medicine. 21 (3). Johns Hopkins University Press: 377–378. JSTOR 44441156. PMID 20257377.
  15. Griffith, H. K. (September 1930). "A Case of Lithopædion". Proceedings of the Royal Society of Medicine. 23 (11): 1542. ISSN 0035-9157. PMC 2182179. PMID 19987758.
  16. "Unusual case is treated by colored doctor". Yazoo Herald. Yazoo City, Mississippi. 13 October 1933. p. 1. Archived from the original on 12 November 1996. Retrieved 6 January 2018. Dr. Miller states that he knew there was a growth of some kind in the stomach besides the tumor, and was much surprised after removing the tumor to discover a lithopaedion, a dead foetus (child) that had become petrified to the right of the tumor.
  17. Chase, A. L. (1968). "Lithopedion". Canadian Medical Association Journal. 99 (5): 226–30. PMC 1924357. PMID 5671128.
  18. Srisomboon, Jatupol; Maneewattana, Trong; Simarak, Suri; Koonlertkij, Sompong; Sirivatanapa, Pannee (March 1988). "Chronic abdominal pregnancy (Lithopedion): A case report". Chiang Mai Medical Journal. 27 (1): 45–52. Archived from the original on 24 April 2019. Retrieved 10 February 2014.
  19. Chang, C M; Yu, K J; Lin, J J; Sheu, M H; Chang, C Y (1 June 2001). "Lithopedion". Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China ed. 64 (6): 369–372. ISSN 0578-1337. PMID 11534806.
  20. Frayer CA, Hibbert ML; Hibbert (July 1999). "Abdominal pregnancy in a 67-year-old woman undetected for 37 years. A case report". The Journal of Reproductive Medicine. 44 (7): 633–35. PMID 10442329.
  21. "Zahra Aboutalib – The 46 Year Pregnancy". RareHumans.com. Archived from the original on 27 July 2013. Retrieved 21 August 2013.
  22. Rosenhek, Jackie (September 2008). "Fetal rock". Doctor's Review. Montreal: Parkhurst. Archived from the original on 24 April 2019. Retrieved 21 August 2013.
  23. "The 46-Year Pregnancy". Extraordinary People. Season 3. Episode 1. 23 March 2005. 60 minutes in. Channel 5 (UK).
  24. Lachman, N; Satyapal, KS; Kalideen, JM; Moodley, TR (2001). "Lithopedion: a case report". Clinical Anatomy. 14 (1): 52–54. doi:10.1002/1098-2353(200101)14:1<52::AID-CA1009>3.0.CO;2-H. PMID 11135399. S2CID 21390235.
  25. Kim, Mi Suk; Park, Soyoon; Lee, Tae Sung (April 2002). "Old abdominal pregnancy presenting as an ovarian neoplasm". Journal of Korean Medical Science. 17 (2): 274–75. doi:10.3346/jkms.2002.17.2.274. PMC 3054860. PMID 11961318.
  26. Burger, Natalie Z.; Hung, Y. Elizabeth; Kalof, Alexandra N.; Casson, Peter R. (May 2007). "Lithopedion: laparoscopic diagnosis and removal" (PDF). Fertility and Sterility. 87 (5): 1208–1209. doi:10.1016/j.fertnstert.2006.11.065. PMID 17289039. Archived (PDF) from the original on 27 March 2023. Retrieved 9 May 2023.
  27. Contreras, Claudia; López, Virgilio Cardona (2006). "Litopedión" (PDF). Revista Médica Hondureña (in Spanish). 74 (3). Tegucigalpa, Honduras: Colegio Médico de Honduras: 782. Archived (PDF) from the original on 23 September 2015. Retrieved 16 November 2013.
  28. Ede, J; Sobnach, S; Castillo, F; Bhyat, A; Corbett, JH (August 2011). "The lithopedion – an unusual cause of an abdominal mass". South African Journal of Surgery. 49 (3): 140–41. PMID 21933501.
  29. Folley, Dr. Andrew (28 October 2011). "Stone baby". contemporaryobgyn.net. Archived from the original on 3 December 2022. Retrieved 9 May 2023.
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