Lithopedion: laparoscopic diagnosis and removal

Area of Science:

• Obstetrics and Gynecology
• Reproductive Medicine
• Surgical Pathology

Background:

• Abdominal pregnancies are rare, with lithopedions representing an even rarer outcome where fetal and placental tissues calcify over time.
• Diagnosis is often delayed due to nonspecific symptoms or lack of suspicion, with discovery frequently occurring incidentally during unrelated procedures.
• The management of lithopedions is complex, often involving surgical intervention due to risks of infection, hemorrhage, and chronic pain.

Observation:

• A young woman presenting for laparoscopic evaluation of infertility was incidentally found to have a lithopedion.
• The lithopedion was identified during the diagnostic laparoscopy, revealing a calcified mass consistent with a long-standing abdominal pregnancy.
• No prior history suggestive of a retained calcified fetus was reported by the patient.

Findings:

• The case demonstrates the incidental discovery of a lithopedion during a laparoscopy for infertility.
• Histopathological examination confirmed the presence of calcified fetal and placental tissues, characteristic of a lithopedion.
• This finding underscores the potential for undiagnosed abdominal pregnancies to persist and calcify.

Implications:

• This case emphasizes the importance of considering rare obstetric complications even in patients presenting for unrelated gynecological issues.
• The incidental finding of a lithopedion highlights diagnostic challenges and the value of thorough intraoperative assessment.
• Further understanding of lithopedion formation and presentation can improve diagnostic accuracy and patient management in reproductive medicine.