Endometrial Osseous Metaplasia Research Articles

Bone in the Womb: A Case Report of Endometrial Osseous Metaplasia

Introduction: Osseous metaplasia in the endometrium is a rare pathological condition characterised by the presence of mature bone, potentially leading to menorrhagia and infertility. The probable pathogenesis of this condition is metaplastic alterations in the endometrial stromal cells, leading to the formation of bony spicules. The gold standard for diagnosis of the condition remains histopathological examination, aided by radiological findings. Methods: This was a case report of a single case with evidence-based discussions. Informed consent was obtained. Case report: We present a case of a 26-year-old female with a previous lower segment caesarean section (LSCS) five years ago and an abortion, followed by dilation and curettage three years ago, presented with heavy menstrual bleeding. Trans-vaginal ultrasound revealed bright, highly echogenic and linear echo-reflective shadows in the endometrial cavity. The complete removal of bony spicules from the endometrium was done by hysteroscopy under sonographic guidance. On histology, a diagnosis of osseous metaplasia of the endometrium was given. Conclusion: The accuracy of the diagnosis is pivotal; it signifies a reversible factor contributing to infertility. Therefore, an accurate identification not only aids in appropriate treatment but also offers substantial relief and hope for those experiencing fertility challenges due to this condition.

Bone within the endometrium: An uncommon cause of secondary infertility

Endometrial osseous metaplasia is an uncommon non-neoplastic gynecological condition, resulting in formation of mature or immature bone within the endometrial stroma. Most cases present with secondary infertility following an abortion. Although hysteroscopy is considered gold standard for the diagnosis of this rare entity, ultrasound (USG) plays an important role in its initial diagnosis. It is a challenging diagnosis due to its infrequency and similarity to other uterine pathologies. The characteristic USG appearance showing multiple bone fragments within the endometrium suggests the diagnosis. The current case report aims to highlight the role of USG in the detection and evaluation of the endometrial osseous metaplasia in patients presenting with secondary infertility.

The bare bones of endometrial osseous metaplasia

Endometrial osseous metaplasia (EOM) is a rare clinical entity that should be considered in the differential diagnosis of menstrual irregularities, chronic pelvic pain and infertility. Its pathogenesis is still widely debated. Two prominent theories include metaplastic transformation and persistence of embryonic or fetal tissue. Ultrasonographic imaging is often first-line in suspecting EOM with hyperechoic linearities seen within the cavity. Further diagnostic and therapeutic benefit can be achieved through hysteroscopic techniques to remove this tissue. Removal has been shown to improve fertility and menstrual symptoms and can provide patients and providers with a diagnosis.

Endometrial Osseous Metaplasia: An Hysteroscopic Incidental Finding - An Overview.

Endometrial osseous metaplasia (EOM) is an uncommon clinical entity with the presence of bone in the endometrium which requires clinical and therapeutic framework. It is also described by various other names such as endometrial ossification, ectopic intrauterine bone, and heterotopic intrauterine bone. Ossification could have various locations as the cervix the ovary, and the vagina. This overview highlights the attention on the actual pivotal points of EOM.

The Bare Bones of Endometrial Osseous Metaplasia

<h3>Study Objective</h3> To describe the background, pathogenesis, and clinical symptomatology of endometrial osseous metaplasia (EOM). To outline the work-up and management of patients with suspected EOM. To highlight key considerations in managing patients with EOM. <h3>Design</h3> A Case Report. <h3>Setting</h3> Tertiary Care Academic Centre. <h3>Patients or Participants</h3> Case report of a patient with endometrial osseous metaplasia. <h3>Interventions</h3> N/A. <h3>Measurements and Main Results</h3> In this video, we present the case of a healthy 39-year-old with a known history of endometriosis who presented with menstrual irregularities and chronic pelvic pain with suprapubic cramping. An advanced transvaginal ultrasound demonstrated echogenic linearities predominantly within the uterine cavity with some extension into the myometrium. Previous uterine instrumentation history includes two early pregnancies treated by D&C as well as two prior IUDs that were documented to have been removed. Endometrial biopsy revealed sampling of normal endometrial tissue without comment of any abnormalities in the tissue obtained. Operative hysteroscopy was performed with findings of osseous trabecular tissue embedded within the myometrium. <h3>Conclusion</h3> This uncommon pathologic entity is important to recognize as a potential cause for chronic pelvic pain, menstrual irregularities and fertility issues. Appropriate detection with ultrasound first-line can help to increase suspicion of this phenomenon. Ultimate investigation via hysteroscopic removal of abnormal tissue with sampling of the underlying endomyometrium is necessary for diagnosis and treatment of symptoms.

Endometrial osseous metaplasia with secondary infertility.

A 32-year-old woman with a history of an early pregnancy loss followed by a term birth presented to her gynecologist with difficulty conceiving and amenorrhea. Her second pregnancy, the live birth, had resulted in a vaginal delivery followed by manual removal of an adherent posterior placenta.

Osseous metaplasia of the endometrium: A multicenter retrospective study

ObjectiveTo describe clinical and demographic characteristics, ultrasound appearance, and hysteroscopic outcomes of patients with endometrial osseous metaplasia. Study designWe conducted a multicenter retrospective study. We retrospectively reviewed the medical records of all consecutive patients who were referred for hysteroscopy at fourteen institutions in Venezuela, Spain, Morocco, India, Ukraine, Argentina, the United States, and Italy between 1994 and 2018. We identified and included all patients who had a diagnosis of osseous metaplasia at the pathologic report, and data were retrieved from the medical records. ResultsBetween January 1st, 1994, and December 31st, 2018, 63 patients out of a total of 419,673 women who underwent hysteroscopy had a diagnosis of osseous metaplasia (0.015%). Most patients were 31–40 years old (53.7%), were Caucasian or Hispanic (95.5%), and had at least one previous pregnancy (86.9%). Forty-one out of 63 patients (65.1%) had at least one miscarriage before the index hysteroscopy. Dysmenorrhea, abnormal uterine bleeding, and infertility were reported by 34.9%, 27.0%, and 23.8% of patients. 14.3% of women were asymptomatic. Preoperative transvaginal ultrasound was available and identified a hyperechoic area of variable size with posterior acoustic shadowing in all cases. Hysteroscopy was successful without complications in all 63 cases. Follow-up data were available in 30.2% of patients: 69.2% of patients were infertile, and 44.4% of them conceived and achieved a live birth; all other symptoms improved after hysteroscopic treatment in all patients. ConclusionsOsseous metaplasia appears associated with multiple unspecific gynecologic symptoms without the predominant role of infertility, as previously suggested. Although endometrial osseous metaplasia is rare, gynecologists should consider this pathologic condition when the characteristic ultrasound appearance is detected, being hysteroscopic treatment effective.

Endometrial osseous metaplasia in a patient with secondary infertility referred for hysterosalpingogram with ultrasound.

Endometrial osseous metaplasia is a rare entity resulting in the formation of trabecular bone fragments within the uterine cavity and frequently presents as secondary infertility with a history of previous pregnancy loss or termination. The unusual transvaginal ultrasound appearances are important to recognise, as fertility is often restored after hysteroscopic removal of the bone fragments from the uterine cavity.

Imaging of endometrial osseous metaplasia\u2014an uncommon but treatable cause of infertility

BackgroundEndometrial osseous metaplasia (EOM) is an uncommon condition characterised by metaplastic transformation of endometrial tissue into osteoblasts (mature or immature bone in the endometrium). Etiopathogenesis of EOM is explained by multiple putative mechanisms like dystrophic calcification, metaplastic ossification, retained foetal bones after abortions and genito-urinary tuberculosis. EOM has varied clinical presentation ranging from patient being asymptomatic to secondary infertility. Although hysteroscopy is the gold standard for its diagnosis and treatment, non-invasive imaging comprising chiefly of ultrasonography (USG) is increasingly becoming the mainstay of diagnosis. We aim to present the imaging findings in EOM to acquaint radiologists and gynaecologists with this condition to avert misdiagnosis of this uncommon yet treatable cause of infertility.ResultsMean age of patients was 31.4 ± 5.4 (S.D) years. USG revealed linear or tubular densely echogenic endometrium with posterior acoustic shadowing in all the 14 patients. MRI in 3 patients revealed diffuse or patchy areas of T1W and T2W hypointense signal intensity with unilateral (n = 2) and bilateral (n = 1) ovarian cysts. One patient who underwent CT scan revealed dense endometrial calcification. Histopathologic examination (HPE) revealed lamellar (n = 6) or trabecular (n = 4) bone within endometrium (EOM) and inflammatory cells with calcification in four patients (calcific endometritis). Twelve patients conceived after dilatation and curettage within 15 months.ConclusionFamiliarity with the imaging appearances of EOM is indispensable to clinch this diagnosis and avert misdiagnosis of this rare but potentially treatable cause of infertility. USG is usually sufficient for diagnosis. MRI and CT are only supplementary tools in difficult clinical scenarios.

Endometrial osseous metaplasia and endometritis in a Thoroughbred broodmare

Endometrial osseous metaplasia is a condition characterised by the presence of mature bone fragments within the endometrium. It is rarely reported in human beings and other domestic mammals, but to...

Endometrial Osseous Metaplasia Associated with Infertility. Hysteroscopic Approach

Endometrial Osseous Metaplasia Associated with Infertility. Hysteroscopic Approach

Métaplasie osseuse de l’endomètre : à propos d’un cas

Endometrial osseous metaplasia (EOM) is a rare condition characterised by the presence of bone in the uterine cavity. Some patients with this condition present with secondary infertility due to the presence of a foreign body in the endometrium. We report a case of a 39-year-old woman who presented with secondary infertility due to EOM. EOM is a rare cause of infertility that can be easily managed by hysteroscopic removal of the bony fragments.

Endometrial osseous metaplasia: Presentation of two rare cases related with infertility, and their hysteroscopic approaching

Objective: To present two cases of patients diagnosed of endometrial osseous metaplasia related with infertility and their hysteroscopic approaching.&#x0D; Design: Case report.&#x0D; Setting: Two clinical cases diagnosed and treated at Institutional University Hospital. Patients: Two premenopasual women diagnosed and treated in our Center.&#x0D; Interventions: Transvaginal ultrasound scan, diagnostic hysteroscopy and hysteroscopic removal of bone fragments. Main Outcome Measures: Ultrasound scan during further clinical follow up.&#x0D; Results: Both patients underwent a diagnostic hysteroscopy, and removal of all the bone fragments with total resolution of their pathology.&#x0D; Conclusions: Endometrial osseous metaplasia is a rare pathology that should be suspected in patients with a history of secondary infertility, several miscarriages and curettages, that present with an ultrasound image compatible with an intrauterine device. Hysteroscopic approach is the best diagnostic and therapeutic option.&#x0D; &#x0D; Key words: Endometrial osseous metaplasia, bony intrauterine tissue, miscarriage, infertility, hysteroscopy, unadverted intrauterine device.

Self-limiting thoracic aortic dissection during bronchial artery embolization.

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Endometrial osseous metaplasia: sonographic, radiological and histopathological findings.

Endometrial osseous metaplasia: sonographic, radiological and histopathological findings.

Osseous metaplasia of the cervix: A rare transformation.

Although numerous cases of endometrial osseous metaplasia appear in the literature, only 6 cases of osseous metaplasia of the cervix have been reported since 1982. A 30 years old nulligravida women was referred to our colposcopy clinic with cervical mass. General, gynecologic and colposcopic assessments were done. The patient had an excision biopsy. Diagnosis of cervical osseous metaplasia was confirmed on histologic examination. The cervical epithelium has the potency to differentiate to multiple types of epithelium including osseous epithelium.

An incidental finding of endometrial osseous metaplasia during office hysteroscopy

An incidental finding of endometrial osseous metaplasia during office hysteroscopy

Intrauterine foreign bodies, other than contraceptive devices and systems, may affect fertility – Report of two very different cases

Objectives To present two cases in which foreign bodies in the uterine cavity had a contraceptive effect for the duration of their presence in utero. Case One case of endometrial osseous metaplasia and another case with unabsorbed suture material after a caesarean section resulted in foreign bodies acting like an intrauterine contraceptive. Ultrasound was used to diagnose the conditions, and hysteroscopy to remove the foreign bodies. Conclusion Foreign intrauterine bodies should be considered in cases of infertility.

Endometrial osseous metaplasia: Case report with literature review

Endometrial osseous metaplasia is a rare pathological condition with mature bone in the endometrium and can be a cause for menorrhagia and infertility as bone in the endometrium acts like intrauterine contraceptive device. We report one such case with brief review of literature in a 28-year-old woman presenting with history of menorrhagia.

Chronic renal failure and endometrial osseous metaplasia: a hypothetical pathway

Chronic renal failure and endometrial osseous metaplasia: a hypothetical pathway