Incidentally Detected Lithopedion in an 87-Year-Old Lady

Abstract

A lithopedion is a rare complication of pregnancy that occurs when a fetus in an intraabdominal location dies, and it is too large to be reabsorbed by the body. The case was an 87-year-old woman, and she was transferred to the morgue department in April 2014 to determine the cause of death. During autopsy, an intraabdominally located calcified dead fetus and a 12-cm diameter calcified cyst in the right ovary were incidentally detected. It was aged 25 to 29 weeks (according to femur and humerus measurements) with a size of 12.5 × 8 × 5 cm and a weight of 227 g. According to investigation reports, her husband died in 1990, and she had 3 deliveries, the most recent of which was in 1946. Because the menopause age of the case was not exactly known, the retention time of the lithopedion was supposed to be 24 to 68 years according to the date of the most recent pregnancy and the date of her spouse's death. It is the first case that has been incidentally detected and identified during an autopsy in Turkey and also one of the oldest cases in the literature.

Lithopedion as a factor in post‐traumatic intestinal perforation

“…Many authors report that lithopedion formation occurs in 1.5%-2% of ectopic pregnancies [4] and in 0.8%-2% of abdominal pregnancies [2].…”

“…The age of patients at diagnosis is variable, generally estimated to be between 20 and 100 years. However, two‐thirds of them are over 40 years of age when the lithopedion is discovered [4].…”

“…to be between 20 and 100 years. However, two-thirds of them are over 40 years of age when the lithopedion is discovered [4].…”

“…It may be manifested by clinical signs such as abdominal pain [3]. It may also be discovered during surgery for a completely different indication or during imaging or autopsy examinations [4].…”

Neglected intrauterine fetal demise for more than two decades leading to the development of a lithopedion: a case report

“…Most of the cases may remain asymptomatic for a long period of time or present with persistent or recurrent abdominal pain and obstructive symptoms of the bowel and urinary system. It can also present with complications such as pelvic abscess, cephalopelvic disproportion in future pregnancies, extrusion of fetal parts through the abdominal wall, rectum or vagina fistula formation, tubal infertility, and lithopedion-induced malignancy [2, 6, 7].…”