Hopefully the title surprised you. If it didn't, your probably not reading this and are severely missing out on a fascinating phenomenon.
Lithopedion, more commonly known as "Stone Baby," is a rare outcome of an ectopic pregnancy in which the fertilized egg implants and grows in the abdomen of a women. Ectopic pregnancies have an incidence rate of 2.1% with 95.6% of them becoming ruptured ectopic pregnancies which can be fatal if untreated (Lawani et al., 2013). Ectopic pregnancies are thus 10 times more dangerous than childbirth and 50 times more dangerous than legal abortions (Dorfman, 1987). Lithopedion accounts for only 1.5%-2.0% of ectopic pregnancy cases (Gaye et al., 2022).
In the case of Lithopedion, the fertilized egg is attached some where in the abdomen, outside of the uterus. The fetus will grow to an extent but then will die due to various suggested reasons, one being a lack of vasculature needed to support the growing fetus. Once dead, the fetus is already too big to be reabsorbed by the mother's body. Instead, a calcium shell is formed around the dead fetus calcifying it and preventing it from degrading and casing damage to the mother's body. (Morales et al., 2020)
Lithopedion is usually asymptomatic, undiagnosed, found due to other procedures, and incredibly rare with only 330 known cases (Morales et al. 2020). One such case a 76-year old female was having a total hysterectomy when doctors found a lithopedion accidentally (Chang et al., 2001). The patient's history had no indication of damage caused by the lithopedion but she did state having a short period of severe abdominal pain 50-years prior that had been diagnosed as a benign-tumor by her physician at the time (Chang et al., 2001). This information indicates that the Stone Baby had safely been calcified and stored in the mother's peritoneal cavity for 50-years (Chang et al., 2001).
How many more mummified babies are out there? We may never know.
References:
1. Dorfman S. F. (1987). Epidemiology of ectopic pregnancy. Clinical obstetrics and gynecology, 30(1), 173–180. https://doi.org/10.1097/00003081-198703000-00024
2. Lawani, O. L., Anozie, O. B., & Ezeonu, P. O. (2013). Ectopic pregnancy: a life-threatening gynecological emergency. International journal of women's health, 5, 515–521. https://doi.org/10.2147/IJWH.S49672
3. Gaye, A. M., Thiam, I., Deguenonvo, G., Guèye, M., Sarr, I., & Dial, C. (2022). Lithopedion as a factor in post-traumatic intestinal perforation. Journal of forensic sciences, 67(5), 2097–2100. https://doi.org/10.1111/1556-4029.15070
4. Morales, A., Aguilera, G., & Krause, D. (2020). Lithopedion: An unusual cause of an abdominal calcified mass. The Indian journal of radiology & imaging, 30(2), 244–245. https://doi.org/10.4103/ijri.IJRI_452_19
5. Chang, C. M., Yu, K. J., Lin, J. J., Sheu, M. H., & Chang, C. Y. (2001). Lithopedion. Zhonghua yi xue za zhi = Chinese medical journal; Free China ed, 64(6), 369–372.
Jack, 10/10 for click bait. This is a super interesting phenomenon. I wonder in what other scenarios the body will envelop a mass in a calcium shell or if this mechanism is solely limited to ectopic pregnancies. Additionally, i would imagine that this condition is far less common now than it was in the past given increased access to prenatal consultations. It would also make sense that this condition is more common in low-income countries where prenatal consultations are less common leading to a larger prevalence of failed ectopic pregnancies that lead to calcification.
ReplyDelete-Case
I agree with Case - great title! I did some research and found some pretty shocking case studies of lithopedions. A large majority of them occurred in remote areas with little knowledge of medical care or access to medical care. One particularly interesting case study involved a woman who had carried the ectopic pregnancy until about 32 weeks. The mother said she was aware of her pregnancy, but when the "baby never came out", she just went about her life. Another fascinating case study recounted a Moroccan woman's ectopic pregnancy. She had gone into labor, but had reached a point where labor was not progressing on its own. She had just witnessed another woman die while having a C-section - she was absolutely terrified of having one herself. She decided to leave the hospital, despite not having a baby to bring home. In her late 50's she had sudden onset abdominal pain and surgeons removed a 7 pound lithopedion!
ReplyDeleteGedam BS, Shah Y, Deshmukh S, Bansod PY. Skeletal remains of mummified foetus for 36 years in mother's abdomen. Int J Surg Case Rep. 2015;7C:109-11. doi: 10.1016/j.ijscr.2014.10.074. Epub 2014 Dec 12. PMID: 25647606; PMCID: PMC4336399.
The title was an immediate hook, I found this so interesting. I have never heard about this specific phenomenon happening. I am now curious as to how it showed more as a benign-tumor then as a calcium shell and if tests have advanced to be able to tell the differences between them now.
ReplyDeleteI was not sure what this post would be about by the title but after reading your post, I am glad I clicked in. It is important to recognize that while these are rare occurrences, they are difficult to diagnose because they are asymptomatic and rely on access to medical care. I found that not only are these found in the abdomen, but an ectopic pregnancy can occur in the ovary and a lithopedion has been found in an ovarian extra-uterine pregnancy that remained in the patient for over a year (Studziński, 1999). In this case, the patient was diagnosed after visualization of a distended and compressed ovary.
ReplyDeleteStudziński, Z., Branicka, D., Filipczak, A., & Oliński, K. (1999). [Prolonged ovarian pregnancy: A case report]. [Przetrwała ciaza jajnikowa--opis przypadku.] Ginekologia Polska, 70(1), 33-35. Retrieved from http://dml.regis.edu/login?url=https://www-proquest-com.dml.regis.edu/scholarly-journals/prolonged-ovarian-pregnancy-case-report/docview/69792217/se-2