A Rare Case of Lithopaedion: A Calcified Legacy of Chronic Tubal Ectopic Pregnancy

Abstract

Introduction
Lithopaedion, or “stone baby,” is an extremely rare complication of abdominal or tubal ectopic pregnancy where the fetus dies and undergoes calcification instead of resorption. Fewer than 300 cases have been reported worldwide, making it a medical rarity. This case underscores the importance of early diagnosis and complete management of ectopic pregnancies, particularly in low-resource settings where incomplete abortions or delayed care may lead to such unusual outcomes. It enriches the global literature by documenting a rare pathology and reinforcing vigilance in chronic pelvic pain and abnormal bleeding in reproductive-age women.
Patient Concerns and Clinical Findings
Chief Complaints:
Intermittent abdominal pain for 3 years
Spotting per vaginam for 1.5 months
Clinical Examination:
Mild tenderness in the lower abdomen
No palpable mass on abdominal or bimanual examination
Imaging Findings:
Ultrasound and CT Abdomen: Revealed a mummified, crumpled fetal skeleton in the left adnexa, separate from the ovary
MRI: Confirmed a calcified fetal structure with skeletal elements consistent with a chronic tubal ectopic pregnancy of approximately 21 weeks gestational age
Diagnosis, Interventions, and Outcomes
Final Diagnosis:
Lithopaedion secondary to chronic left tubal ectopic pregnancy
Management:
Surgical removal of the calcified mass via laparotomy
Histopathological confirmation of calcified fetal tissues
Postoperative recovery was uneventful
Outcome:
The patient had symptomatic relief from abdominal pain and no further spotting
Counseling provided regarding early antenatal care in future pregnancies

Conclusion and Key Takeaways
Lithopaedion is a preventable complication of untreated or partially treated ectopic pregnancies.
In women presenting with chronic abdominal pain and abnormal bleeding, especially with a remote history of missed pregnancy or incomplete abortion, rare pathologies like lithopaedion should be considered.
Imaging modalities like CT and MRI are essential in confirming the diagnosis.
This case emphasizes the critical role of early diagnosis and complete evacuation in ectopic pregnancies to prevent severe complications such as lithopaedion.