Abstract
ObjectivesHere, we report a case of simultaneous osseous metaplasia nodules of the submucosa and mesosalpinx after a first trimester abortion.Case presentationA 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.ConclusionsOsseous 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.
Highlights
Osseous metaplasia occurs in approximately 3 in every 10,000 women [1]
Osseous metaplasia nodules in the submucosa and mesosalpinx can be a rare cause of vaginal bleeding and infertility
Treatment is by ultrasound-guided curettage or by hysteroscopic and laparoscope removal
Summary
Osseous metaplasia occurs in approximately 3 in every 10,000 women [1]. Retained fetal bones and inflammatory response following the abortion are thought to be the reasons for endometrial ossification [3]. Bony fragments in the uterus occur after second trimester termination of pregnancy [1,2,3]. Bony fragments can form following first trimester loss [4]. The clinical presentation of osseous metaplasia can be pelvic pain, vaginal bleeding, menstrual irregularities, dyspareunia, and secondary infertility [2,3,5]. Osseous metaplasia is diagnosed by ultrasound examination, revealing an echogenic band, and diagnosis can subsequently be confirmed by hysteroscopy [1,2,6].
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