Multimodality imaging of lithopedion in a postmenopausal woman: A case report emphasizing the diagnostic role of noncontrast computed tomography.
5 affiliations
- 1Shree Birendra Hospital, Kathmandu, Nepal.
- 2Mahakali Provincial Hospital, Mahendranagar, Nepal.
- 3Nepalese Army Institute of Health Sciences, Kathmandu, Nepal.
- 4Rapti Academy of Health Sciences, Gorahi, Nepal.
- 5Peoples Dental College, Kathmandu, Nepal.
Abstract
Lithopedion is a rare sequela of unrecognized extrauterine pregnancy in which a nonviable fetus undergoes calcification and may retain for years, that occurs in approximately 0.005% of entire pregnancies and 1.5%-1.8% among abdominal ectopic pregnancies. We present a case of 62-year-old postmenopausal woman (Para 5) presenting with chronic pelvic pain and progressive abdominal distention secondary to a presumed retention period of approximately 23 years following an unevaluated gestation. Ultrasound demonstrated a large solid, echogenic mass within the pelvis with posterior acoustic shadowing suggesting the presence of fetal bones. Radiographs revealed a calcified fetal skeleton. Noncontrast computed tomography showed features consistent with true lithopedion (14.0 × 9.4 × 6.4 cm) with a femoral diaphysis length of 57.2 mm which corresponded to an approximate early third-trimester gestational age of 30 weeks. Multiplanar computed tomography demonstrated mild extrinsic compression on the urinary bladder dome without luminal obstruction, mural invasion, bowel obstruction, inflammatory fat stranding, or free fluid. Because of the absence of acute complication and patient's preference to avoid surgery, conservative management was employed with regular outpatient monitoring. This case highlights the importance of noncontrast computed tomography for anatomical characterization with biometry estimation and most importantly for excluding acute complications, therefore guiding safe and individualized conservative management in asymptomatic elderly patients.
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BibTeX
@article{maharjan2026multimodality,
title = {{Multimodality imaging of lithopedion in a postmenopausal woman: A case report emphasizing the diagnostic role of noncontrast computed tomography.}},
author = {Seejana Singh Maharjan and Saroj Sitaula and Pravakar Dawadi and Brikshya Gurung and Sabina Sitaula and Robert Singh Maharjan},
journal = {Radiology case reports},
year = {2026},
month = oct,
doi = {10.1016/j.radcr.2026.09.082},
url = {https://europepmc.org/article/MED/42927242},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Multimodality imaging of lithopedion in a postmenopausal woman: A case report emphasizing the diagnostic role of noncontrast computed tomography.
AU - Seejana Singh Maharjan
AU - Saroj Sitaula
AU - Pravakar Dawadi
AU - Brikshya Gurung
AU - Sabina Sitaula
AU - Robert Singh Maharjan
PY - 2026
DA - 2026/10/16
JO - Radiology case reports
DO - 10.1016/j.radcr.2026.09.082
UR - https://europepmc.org/article/MED/42927242
AB - Lithopedion is a rare sequela of unrecognized extrauterine pregnancy in which a nonviable fetus undergoes calcification and may retain for years, that occurs in approximately 0.005% of entire pregnancies and 1.5%-1.8% among abdominal ectopic pregnancies. We present a case of 62-year-old postmenopausal woman (Para 5) presenting with chronic pelvic pain and progressive abdominal distention secondary to a presumed retention period of approximately 23 years following an unevaluated gestation. Ultrasound demonstrated a large solid, echogenic mass within the pelvis with posterior acoustic shadowing suggesting the presence of fetal bones. Radiographs revealed a calcified fetal skeleton. Noncontrast computed tomography showed features consistent with true lithopedion (14.0 × 9.4 × 6.4 cm) with a femoral diaphysis length of 57.2 mm which corresponded to an approximate early third-trimester gestational age of 30 weeks. Multiplanar computed tomography demonstrated mild extrinsic compression on the urinary bladder dome without luminal obstruction, mural invasion, bowel obstruction, inflammatory fat stranding, or free fluid. Because of the absence of acute complication and patient's preference to avoid surgery, conservative management was employed with regular outpatient monitoring. This case highlights the importance of noncontrast computed tomography for anatomical characterization with biometry estimation and most importantly for excluding acute complications, therefore guiding safe and individualized conservative management in asymptomatic elderly patients.
SN - 1930-0433
ER -