DIFFERENTIAL DIAGNOSIS OF A CALCIFIED CYST FOUND IN AN 18TH CENTURY FEMALE BURIAL SITE AT ST. NICHOLAS CHURCH CEMETERY (LIBKOVICE, CZECHIA).

In the St. Nicholas Church archaeological site (Libkovice, Czechia; the 18th century cemetery) a female skeleton with a stone object in the left iliac fossa was found. It was a cyst-like structure. The measures of it were 54 mm in length and 35 mm in maximum diameter. Within the object fetal bones (long bones, i.e. femur and two tibias, two scapulas, three ribs, vertebrae and other tiny bone fragments) were revealed. The methods used for the analysis were intended to describe the external and internal morphology of the object and its content: X-ray, CT imaging, SEM, histological staining and EDS. The EDS analysis revealed the presence of primarily oxygen, calcium and phosphorus in bone samples, and oxygen and silicon, in stone shell. The measurements of the femur (20.2 mm) and tibia (16 mm) shafts allowed to estimate the fetal age as the 15-18 week of pregnancy. During the differential diagnosis three most likely cases were taken into account: fetiform teratoma (FT), fetus-in-fetu (FIF) and lithopedion. FT was excluded due to the presence of long bones and their proportions, and due to the presence of an anatomically correct spine. Of the other two possible variants, fetus-in-fetu is more likely than lithopedion, due to the lack of a skull, better development of lower limbs, and low calcium content in the shell. The results do not allow to clearly answer the question which of these two cases is the object due to the insufficient number of similar discoveries in the excavation material. [ABSTRACT FROM AUTHOR]