Rare Calcified Fetus Found During Autopsy Reveals Decades-Old Ectopic Pregnancy

In a remarkable and tragic case, doctors at Aristide Le Dantec Hospital in Dakar, Senegal, discovered a calcified fetus – known as a lithopedion – during an autopsy of a 72-year-old woman. The discovery highlights the rare phenomenon where a dead fetus remains undetected within the body for decades.

What is a Lithopedion?

A lithopedion, literally meaning “stone baby,” is a rare condition where a non-viable fetus calcifies within the mother’s abdomen. This occurs when a fertilized egg implants outside the uterus, typically in a fallopian tube (ectopic pregnancy) and the fetus dies but isn’t expelled from the body. Over time, the fetal tissue becomes encapsulated by calcium deposits, effectively turning it into a stone-like mass. According to research, several hundred cases of lithopedions have been documented in women of middle to advanced age. Journal of Forensic Sciences

The Case in Senegal

The patient presented to the emergency room with severe abdominal pain after reporting a physical altercation with her stepson. Initial investigations, including an ultrasound, revealed a large, bulky mass with calcifications in her abdomen. A CT scan was recommended, but the patient was unable to afford it.

Due to limited hospital bed availability during the COVID-19 pandemic, the woman was sent home with pain medication. Tragically, she was found dead two days later. A police-requested autopsy was performed to determine the cause of death.

Autopsy Findings and Cause of Death

The autopsy revealed no external signs of trauma. However, internal examination uncovered half a liter of pus within the abdomen and a perforation in the final section of the minor intestine. Most significantly, the forensic doctor discovered the lithopedion. The calcified fetus, from an ectopic pregnancy, had gone unnoticed for decades.

The fetus measured 15 centimeters in length and weighed 750 grams. Estimates based on the femur length indicated the pregnancy had ceased development around 37 weeks of gestation – the beginning of the ninth month. Futura Sciences

The doctors determined that the blow to the abdomen had dislodged the lithopedion, causing it to perforate the small intestine. This intestinal perforation was the direct cause of death. The death was ruled a homicide.

Lithopedions and Long-Term Health

Even as lithopedions can remain asymptomatic for many years, they can potentially cause complications such as chronic pain, intestinal obstruction, or, as seen in this case, fatal perforation. The body can tolerate a dead fetus for over 50 years, but the risk of complications increases over time.

Forensic Investigations in Dakar

Forensic thanatological activities in Dakar are primarily conducted at Aristide Le Dantec Hospital and the General Hospital of Grand Yoff. A retrospective study of 644 homicide cases between 1997 and 2007 revealed that hand-held weapons were the most common instruments used in homicides (89.7%), followed by firearms (6.8%). ScienceDirect

Key Takeaways

• Lithopedions are extremely rare occurrences where a dead fetus calcifies within the mother’s abdomen.
• Ectopic pregnancies are the primary cause of lithopedion formation.
• These calcified fetuses can remain undetected for decades, but can lead to serious, even fatal, complications.
• This case underscores the importance of thorough medical investigation, even in the absence of obvious trauma.