A probable secondary infertility due to osseous metaplasia of the endometrium

Long and fluctuating bone fragments in uterine isthmus: a curious feature of true osseous metaplasia

Osseous metaplasia in the uterine cavity is a rare phenomenon arising from an unusual transformation of non-osseous connective tissue into mature bone. It is unclear how this alteration occurs and it has no single clinical manifestation. We report a case of asymptomatic endometrial osseous metaplasia of the isthmus with a singular picture: numerous long, floating bone-like structures in the cavity. The lesion was treated by operative hysteroscopy. Histological findings described a rare picture of true osseous metaplasia with the extraordinary presence of cells referable to areas of hematopoietic tissue in the cavities of trabecular bone. Physicians should be more informed and alert regarding this rare disorder in all its strange shapes and localizations, so as to be able to follow suitable therapy.

Simultaneous osseous metaplasia nodules of the submucosa and mesosalpinx after first trimester abortion: a case report

OBJECTIVES

Here, we report a case of simultaneous osseous metaplasia nodules of the submucosa and mesosalpinx after a first trimester abortion.

CASE PRESENTATION

A 36-year-old woman presented to the Women's Hospital, School of Medicine, Zhejiang University with vaginal bleeding and infertility resulting from osseous metaplasia nodules of the submucosa and mesosalpinx after a first trimester abortion. Diagnostic and operative hysteroscopy and laparoscope procedures were performed. The osseous metaplasia nodules disappeared after hysteroscopy and laparoscope interventions; 2 weeks postoperatively, the patient underwent a transvaginal ultrasound examination and the abnormal ultrasound appearance had resolved.

CONCLUSIONS

Osseous metaplasia nodules in the submucosa and mesosalpinx can be a rare cause of vaginal bleeding and infertility. Autologous tissue, not persistent heterologous tissue, may be the true reason for metaplasia. Treatment is by ultrasound-guided curettage or by hysteroscopic and laparoscope removal.

Osseous metaplasia of the cervix and endometrium: a case of secondary infertility

OBJECTIVE

To report a case of osseous metaplasia of the cervix and endometrium as a cause of secondary infertility.

DESIGN

Case report.

SETTING

Istanbul Bakirkoy Women and Children Teaching and Research Hospital.

PATIENT(S)

A 31-year-old patient with secondary infertility owing to osseous metaplasia of the endometrium and cervix in whom uterine perforation occurred during the removal of bone fragments.

INTERVENTION(S)

Diagnostic and operative hysteroscopy and laparotomy.

MAIN OUTCOME MEASURE(S)

Visualization of the disappearance of the osseous metaplasia region with transvaginal ultrasound examination after the hysteroscopy intervention.

RESULT(S)

Osseous metaplasia lesions are removed by operative hysteroscopy. During this operation, laparotomy was done because of perforation of the uterine wall, and the perforated area was repaired. Two weeks after surgery, the patient underwent a transvaginal ultrasound examination, and the abnormal ultrasound appearance had resolved.

CONCLUSION(S)

As a rare cause of infertility, osseous metaplasia can be seen in the cervix and the endometrium. If osseous metaplasia is deep enough during operative hysteroscopy, uterine perforation may occur. Clinicians must be careful for this reason, especially in cases of deep osseous metaplasia.

Vaginal osseous metaplasia

BACKGROUND

Osseous metaplasia is an unusual event in the gynecologic organs. It has been reported mostly in the endometrium and rarely in the cervix.

CASE

The authors describe a rare case of bone formation in vaginal mucosa of a 52-year-old woman with chronic pelvic pain and exteriorization of bone from vaginal introit.

CONCLUSION

To our knowledge, this finding has not been reported yet in the English medical literature.