medigraphic.com
ISSN 2007-3194 (Print)
Órgano de difusión oficial del Instituto Materno Infantil del Estado de México

2025, Number 1

<< Back Next >>

Arch Inv Mat Inf 2025; 16 (1)

Endometrial bone metaplasia as a cause of infertility: clinical case report

Álvarez-Esparza VG, Castillo-Cruz JR, Barbabosa-Vilchis JA, Olivera-García N, Hernández-Flores SE

Language: Spanish
References: 16
Page: 37-41
PDF size: 767.42 Kb.


ABSTRACT

Introduction: heterotopic ossification is a pathology characterized by the metaplastic transformation of non-bony soft tissues into bones (osseous metaplasia). This condition can be acquired or congenital. Heterotopic ossification in endometrial tissue is rare; infertility is one of its clinical characteristics. Clinical case: a 38-year-old patient reported dyspareunia and abnormal uterine bleeding, as well as a desire for a new pregnancy. A diagnostic hysteroscopy showed multiple images of fragments with whitish, hard, and porous characteristics; these fragments were extracted. Histopathological analysis confirmed the diagnosis of endometrial osseous metaplasia. After extraction, the patient regained fertility and completed a full-term pregnancy at 37.5 weeks of gestation, delivered by abdominal route due to severe preeclampsia. Conclusion: endometrial osseous metaplasia should be suspected in patients without IUD, who are seeking conception and have dyspareunia and abnormal uterine bleeding not related to structural or endocrinological abnormalities, as well as a suspicious hyperechogenic image on ultrasound. The definitive diagnosis in the clinical case was histopathological. Although the pathophysiology was not clear, a history of abortions was considered important due to residual fetal bone material may have been present.


REFERENCES

  1. Jiménez-Bonola A, Valencia-Torres MÁ, Olivares-Montano AK. Metaplasia ósea de endometrio: un raro diagnóstico diferencial de DIU traslocado: tratamiento histeroscópico. Reporte de caso. Ginecol Obstet México. 2021; 89 (4): 336-342.

  2. Basu M, Mammen C, Owen E. Bony fragments in the uterus: an association with secondary subfertility. Ultrasound Obstet Gynecol. 2003; 22 (4): 402-406.

  3. Edwards DS, Clasper JC. Heterotopic ossification: a systematic review. J R Army Med Corps. 2015; 161 (4): 315-321.

  4. Tyagi SP, Saxena K, Rizvi R, Langley FA. Foetal remnants in the uterus and their relation to other uterine heterotopia. Histopathology. 1979; 3 (4): 339-345.

  5. Ramírez Carrasco A, Vera Vázquez SA. Metaplasia ósea endometrial. Acta Méd Grupo Ángeles. 2018; 16 (1): 84.

  6. Jha P, Feldstein V. Sonographic findings of endometrial osseous metaplasia, a cause of dysfunctional vaginal bleeding and secondary infertility. J Ultrasound Med. 2017; 36 (12): 2617-2618.

  7. Chotaliya AB, Saifi SGA, Achuthan G. Sonographic appearance of endometrial osseous metaplasia. J Clin Ultrasound. 2018; 46 (8): 536-539.

  8. Singh P, Kapur K, Singla S, Naz N. Endometrial osseous metaplasia and mature bone formation with extramedullary hematopoiesis. J Hum Reprod Sci. 2011; 4 (1): 56-57.

  9. AbdullGaffar B, AlMulla A. Endometrial calcifications. Int J Surg Pathol. 2020; 28 (6): 590-599.

  10. Madaan M, Suman S, Sharma R, Kapoor N, Garg P, Raj SS. Osseous metaplasia of the endometrium and successful hysteroscopic resection: A report of two cases and a review of the literature. Asian J Endosc Surg. 2015; 8 (1): 63-66.

  11. Guerra LF, Pessanha LB, de Oliveira GA, de Melo AM, Braga FS, de Souza RS. Endometrial osseous metaplasia: sonographic, radiological and histopathological findings. Radiol Bras. 2016; 49 (1): 62-63.

  12. Umashankar T, Patted S, Handigund R. Endometrial osseous metaplasia: Clinicopathological study of a case and literature review. J Hum Reprod Sci. 2010; 3 (2): 102-104.

  13. Alsaqobi A, Al-Brahim N. Osseous metaplasia of the cervix: a rare transformation can mimic a tumor—literature review. Case Rep Pathol. 2018; 2018: 1392975.

  14. White J, Hickey J, Gilmour D, Ansari A. Endometrial osseous metaplasia with secondary infertility. Can Med Assoc J. 2022; 194 (25): E868-E869.

  15. Onderoglu LS, Yarali H, Gultekin M, Katlan D. Endometrial osseous metaplasia: an evolving cause of secondary infertility. Fertil Steril. 2008; 90 (5): 2013.e9-2013.e11.

  16. Rosa-E-Silva JC, Barcelos ID, Navarro PA, Rosa-E-Silva AC, Nogueira AA, Ferriani RA. Osseous metaplasia of the endometrium associated with infertility: a case report and review of the literature. J Med Case Rep. 2009; 3: 7427.




2020     |     www.medigraphic.com