Lithopedion Presenting as Diaphragmatic Compression in a Post-Covid Elderly Patient: A Rare Pathological Entity with Radiological–Pathological Correlation

Prerna Gulati, MD; Sandhya Panjeta Gulia, MD; Manish Gulia, MD; Jashan Sandhu, MD; Dayal S. Bisht, MD; Devkanya Saha, SR; Rishi Nabh, MS; Babita Ramdev, DA, DNB

doi:10.36948/ijfmr.2026.v08i01.66406

Lithopedion Presenting as Diaphragmatic Compression in a Post-Covid Elderly Patient: A Rare Pathological Entity with Radiological–Pathological Correlation

Author(s)	Dr. Prerna Gulati, MD, Sandhya Panjeta Gulia, MD, Manish Gulia, MD, Jashan Sandhu, MD, Dayal S. Bisht, MD, Devkanya Saha, SR, Rishi Nabh, MS, Babita Ramdev, DA, DNB
Country	India
Abstract	Abstract Background: Lithopedion, also known as “stone baby,” is an exceedingly rare complication of ectopic pregnancy resulting from fetal demise followed by dystrophic calcification. With fewer than 300 documented cases worldwide since 1582, this condition represents an extraordinary pathological entity that typically remains asymptomatic for decades.Page 1 of 19 Lithopedion Case Report Case Presentation: We report a case of a 77-year-old female who presented with progressive dyspnoea and longstanding abdominal fullness. Her respiratory symptoms were exacerbated by prior COVID-19-related pulmonary damage. Multimodality imaging including contrast-enhanced computed tomography (CECT) and magnetic resonance imaging (MRI) revealed a large calcified abdominal mass (17.5 × 16 × 14 cm, 3,800 grams) containing structures resembling fetal skeletal elements and compressing the left hemidiaphragm. Results: Surgical excision was performed with subsequent histopathological examination confirming the diagnosis of lithopedion. The specimen demonstrated extensive dystrophic calcification, mature cartilage, osseous tissue, skeletal muscle bundles, nervous tissue, and remarkably preserved fetal hair—a finding documented in fewer than 5% of reported cases globally. The patient experienced complete symptomatic relief with full resolution of respiratory symptoms at 6-month follow-up. Conclusion: This case represents the first documented instance of COVID-19-related pulmonary damage unmasking lithopedion symptoms through diaphragmatic compression. It highlights the importance of comprehensive radiological–pathological correlation in diagnosing rare retained ectopic gestations in elderly patients.
Keywords	Keywords: Lithopedion; Calcified fetus; Ectopic pregnancy; Diaphragmatic compression; COVID-19; Stone baby; Dystrophic calcification; Case report
Field	Medical / Pharmacy
Published In	Volume 8, Issue 1, January-February 2026
Published On	2026-01-13
DOI	https://doi.org/10.36948/ijfmr.2026.v08i01.66406

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Lithopedion Presenting as Diaphragmatic Compression in a Post-Covid Elderly Patient: A Rare Pathological Entity with Radiological–Pathological Correlation

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