A woman carried a ‘stone baby’ in her abdomen for 3 years — Diagnostic dilemma

The patient: A 42-year-old woman in Somaliland, Africa

The symptoms: The woman went to the hospital after having three years of chronic, dull pain in her lower abdomen, as well as a growing sense of heaviness in her abdomen that had worsened in recent months.

When doctors reviewed her medical history, they learned that, three years earlier, she had experienced a number of symptoms that seemed to indicate a pregnancy. She recalled her abdomen growing over time and feeling “fetal movements,” her doctors noted in a report of the case. Then, the movements stopped, the abdominal growth halted, and the enlargement gradually subsided. She had not sought medical care during or after this apparent pregnancy.

What happened next: When doctors physically examined the woman’s abdomen, they found a hard, irregular mass that extended to her belly button and barely moved when they touched it. Blood tests showed mild anemia, meaning she had fewer healthy red blood cells than normal. Her white blood cell count and kidney and liver tests were normal, and a pregnancy test was negative.

An ultrasound revealed a calcified mass and an empty uterus. Calcification is a buildup of calcium that hardens tissue into a solid mass.

To get a better look at the mass, which occupied the woman’s lower abdomen and pelvis, the doctors ordered an advanced CT scan to create a 3D model. The imaging revealed that the mass contained clearly identifiable fetal skeletal structures, including a skull, a spinal column, ribs, and arm and leg bones. The mass measured roughly 7 by 5 inches (18 by 13 centimeters).

The diagnosis: Doctors concluded that the woman had a lithopedion, or “stone baby.” The term comes from the Greek words “lithos,” meaning stone, and “paidion,” meaning child.

In a typical pregnancy, an egg is fertilized in a fallopian tube — the structure between the ovaries and the womb — and then travels into the uterus, where it implants in the uterine lining. By contrast, lithopedions most often start as abdominal pregnancies,‬ a type of ectopic pregnancy in which the embryo instead implants on the lining of the abdominal cavity.

There, the embryo shares the space with organs like the stomach, kidneys and appendix. These misplaced pregnancies are almost never viable and are highly life-threatening for the mother. Because the placenta attaches directly to delicate abdominal organs and blood vessels, these carry a severe risk of catastrophic internal bleeding.

If the fetus dies at a developmental stage when it is too large for the mother’s body to naturally break down and absorb, her immune system can sometimes treat the retained tissue as a foreign object. To protect the mother from inflammatory complications and infection, the body progressively deposits calcium over the fetal remains, creating a protective casing. In this case, the calcified fetus likely accounted for the woman’s chronic abdominal pain and increasing sense of heaviness, her doctors concluded.

The treatment: The doctors performed abdominal surgery to completely remove the calcified fetal mass from the woman’s pelvis.

The day after surgery, she developed a mild fever and nausea, but both resolved with treatment. She remained stable and improved during her hospital stay before being discharged in good condition.

Follow-up visits over the next six months showed she had healed well, with a complete resolution of her abdominal pain.

What makes this case unique: Only about 340 cases of lithopedion have been documented in the medical literature over the past 400 years, with the earliest documented in 1582.

This woman’s case stands out because she was 42 years old, while many recent cases have been diagnosed in postmenopausal women. (Women typically experience menopause around 51 to 52 years old.) In these cases, the initial ectopic pregnancy occurred during the woman’s childbearing years, but she unknowingly carried the calcified remains for decades before developing symptoms. For example, a 74-year old woman from India carried her “stone baby” for more than three decades. By contrast, the woman’s recent case was caught after only three years.

The case also highlights the challenges of maternal healthcare in resource-limited settings such as Somaliland, where a lack of access to routine prenatal care and early pregnancy scans can lead to delayed diagnoses. That said, the successful use of advanced 3D imaging and complete surgical recovery demonstrate that excellent outcomes are possible even in these constrained environments, the doctors noted.

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