Korean J Obstet Gynecol.  2012 May;55(5):361-365. 10.5468/KJOG.2012.55.5.361.

A case of endometrial osseous metaplasia treated by hysteroscopic operation

• Lee JY
• Lee HA
• Kwon HM
• Na SH
• Hwang JY
• Lee DH

• KMID: 2078156
• DOI: http://doi.org/10.5468/KJOG.2012.55.5.361

Abstract

Endometrial osseous metaplasia is a very rare disease related to secondary infertility. A 42-year-old woman, a North Korean defector, visited for gynecological exam. She presented with a history of secondary infertility. She had two previous pregnancies and both were voluntarily terminated at 14 and 16 years ago. Vaginal delivery at about 20 weeks in the first gestation 16 years ago; and dilatation and curettage at about 14 weeks 14 years ago were done in a medical facility of North Korea. Vaginal ultrasonography showed an intrauterine structure described as a hyperechogenic image suggesting calcification. Hysteroscopy revealed multiple coral-like white spicules about 1 cm in length in the uterine cavity. The lesion was treated by hysteroscopic removal without complications. Histology established the diagnosis of endometrial osseous. In our case, hysteroscopy was effective in the diagnosis and treatment of endometrial osseous metaplasia.

Keyword

Osseous metaplasia; Hysteroscopy; Secondary infertility

MeSH Terms

Adult
Democratic People's Republic of Korea
Dilatation and Curettage
Female
Gynecological Examination
Humans
Hysteroscopy
Infertility
Metaplasia
Pregnancy
Rare Diseases

Figure

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  Fig. 1 Ultrasonography showing a hyperechogenic band in endometrial cavity.

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  Fig. 2 Computerized tomography shows amorphous high density lesion suggesting calcification in the uterus.

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  Fig. 3 Hysteroscopic finding showing white spicules in the endometrial cavity.

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  Fig. 4 Fragments of osseous metaplasia after hysteroscopic removal. (A) Gross finding of osseous metaplasia. (B) Microscopic appearance showing that osseous metaplasia of the endometrium is seen adjacent to the endometrial glands and stroma (H&E, ×100).

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  Fig. 5 Ultrasonography showing the clear endometrial surface after hysteroscopic operation.

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