A lithopedion (also spelled lithopaedion or lithopædion; from "stone" and "small child, infant"), or stone baby, is a rare phenomenon which occurs most commonly when a fetus dies during an abdominal pregnancy, is too large to be reabsorbed by the body, and calcifies on the outside as part of a foreign body reaction, shielding the host's body from the dead tissue of the fetus and preventing septic infection.
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 at diagnosis of women with lithopedia was 55 years, 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.
According to one report, there are only 300 known cases of lithopedia 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.
Research history
Lithopedion was first described in a treatise by the Spanish Muslim physician Abū al-Qāsim (Abulcasis) in the 10th century. 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.
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.
Reported cases Before 1900 Patient(age at time of diagnosis)LocationDate of pregnancyDate of diagnosis (case duration)Additional informationUnknownBering Sinkhole, modern Kerr County, Texas1100 BCEEarliest known lithopedion, found in an archaeological excavation.Modern Costebelle, France4th century CEFound in a Gallo-Roman archaeological site.Cordoba, II Umayyad CaliphateModern say SpainUnknownLate 10th centuryThe case referred by Abulcasis. The patient was pregnant in two separate occasions but never gave birth. "A long time" after, she developed a large swelling in the navel area, that turned into a suppurating wound and would not heal despite receiving treatment. This continued until Abulcasis removed several fetal bones through the wound, which initially shocked Abulcasis, as he had never known of a similar case. The patient largely recovered her health, but she continued to suppurate through the wound. Lodovia "LaCavalla"Pomponischi, Duchy of Mantua(Modern-day Italy)1540The patient had a failed pregnancy followed by a successful one, after which she fell sick and rapidly lost weight. Christopher Bain, a travelling surgeon, practised an incision and extracted "the skeleton of a male child". She recovered fully and went on to have four more children.Colombe Chatri (68)*Sens, Kingdom of France15541582 (28 years)Chatri became pregnant for the first time at 40, but never gave birth after breaking her water and going through labor pains. She was bedridden for the next three years, during which she noticed a hard tumor on her lower abdomen, and complained of tiredness and abdominal pains for the rest of her life. After her death, her widower requested two physicians to examine her body, who discovered a fully formed, petrified baby girl, with remains of hair and a single tooth. By 1653 the lithopedion had come into the possession of King Frederick III of Denmark, who consented to show it to Thomas Bartholin, but not to examine it further.UnknownPont-à-Mousson, Lorraine, Holy Roman Empire(Modern-day France)16291659 (30 years)Dôle, Franche-Comté, Spanish Empire(Modern-day France)16451661 (16 years)Marguerite Mathieu (62)*Toulouse, Kingdom of France16531678 (25 years)Originally from the Gascon village of Viulas near Lombez, Mathieu gave birth to ten children but only three survived infancy. At 37, she became pregnant, carried to full term and broke her water for the eleventh time, but never gave birth despite the efforts of a physician. She suffered from acute abdominal pain for two months, vaginal bleeding for five months, and felt discomfort for the rest of her life. This only eased when she lay on her back, making her bedridden and she experienced periodic paroxysmal attacks. Her case became notorious and her symptoms were popularly attributed to a spell cast by a sorceress whom Mathieu had rejected as a midwife. She consented to a public, three-day long necropsy after her death, which was attended by four doctors, three surgeons and their assistants. They found the calcified umbilical cord, placenta and a fully formed baby boy inside that weighed 3,916 grams (). The lithopedion was found floating in white, odorless pus, which made it semi-mobile and would explain Mathieu's claim that she could still feel the baby moving inside her. The lithopedion was extensively described and pictured in a published memoir by François Bayle, one of the doctors present.UnknownLeeuwarden, United Provincesc. 16921694 (21 months)A 21-month-old, intra-tubarian lithopedion was removed successfully from a living woman by Cyprien, a teacher of anatomy and surgery at the University of Franeker.Anna Mullern (94)*Leinzell, Swabia, Holy Roman Empire(Modern-day Germany)16741720 (46 years)Aged 48, Mullern became pregnant, broke her water and went through labor pains for seven weeks without giving birth, retaining a swollen belly afterwards. She would suffer pain when exercising for the rest of her life, but she was able to become pregnant again and gave birth to healthy dizygotic twins. Convinced that she had been pregnant and carried the previous baby with her still, Mullern made the local physician and surgeon swear that they would open her body after her death. The physician did not survive her, but the elderly surgeon fulfilled his promise with the help of his son, finding "a hard mass of the form and size of a large Ninepin-Bowl" that contained a petrified fetus. It was examined by George I of Great Britain's personal physician Johann Georg Steigerthal, who wrote an account of it.Marie de Bresse (61)*Joigny, Kingdom of France17161747 (31 years)Patient was in her second pregnancy after a natural abortion four years before. De Bresse took it to full term and underwent labor pains for two days, but never had vaginal dilatation. After the midwife gave up, an assembly of doctors and physicians from Troyes decided unanimously that the best was to perform a cesarean section, but she refused. She continued having abdominal pains for a month and could not resume work before eight. She never regained her period and continued lactating for thirty years. At 61, she was hospitalized for chest inflammation and died shortly after. The autopsy found an oval mass the size of a man's head embedded in her right fallopian tube, which weighed 8 pounds () and contained a fully formed baby boy with hair, two incisors and remains of amniotic fluid. The envelope was not fully calcified. Mrs. BallLondon, Kingdom of Great Britain17411747 (6 years)"A dead infant" was found in the belly, outside of the womb, during an autopsy performed at the request of the patient. In the time between her failed pregnancy and her own death, Ball became pregnant and gave birth four times without complications.UnknownModern Libkovice, Czech Republic18th centuryFound in a burial site at St. Nicholas Church cemetery. Could be lithopedion or fetus in fetu.Randi Jonsdatter (50)Kvikne, Hedmark, Denmark-Norway(Modern-day Norway)18031813 (10 years)Patient "gave birth" to a petrified baby divided in two parts, through a cut performed over Jonsdatter's belly button. She lived for many years after without any further problems.Rebecca Eddy (77)*Frankfort, New York, United Statesc. 18021852 (c. 50 years)Aged 27 and in her first pregnancy, Eddy went through what seemed to be labor pains after an accident with a large kettle over the fire, but the pains disappeared a few days later and she never gave birth. William H. H. Parkhurst examined her in 1842, noting the "largeness, hardness and irregularity" of her abdominal lump; he would perform her autopsy in front of 20 witnesses when she died a decade later. During the process Parkhurst found "a perfect formed child... weighing 6 pounds avoirdupois (2.7 kilograms)" who "had no adhesions or connections with the mother except to the Fallopian tubes, and the blood vessels which nourished it, and which were given off from the mesenteric arteries... the child was almost floating in the abdomen."Sophia Magdalena Lehmann (87)*Zittau, German Empire18231880 (57 years)Lehmann, a widow from Olbersdorf, was diagnosed with lithopedion in 1823 by an obstetrician in Zittau, and treated by Küchenmeister before he moved to Dresden in 1859. Upon her death, Küchenmeister performed her autopsy and used her case to describe the lythokeliphos category.
* After death of the patient.
After 1900