Endometrial osseous metaplasia complicated by secondary infertility: a case report.

Endometrial osseous metaplasia is a rare condition in which there is abnormal presence of bone in the endometrium. There is paucity of reported cases of this pathological condition in Africa and it is usually overlooked as a cause of infertility. Pathogenesis is not well understood but mostly occurs following pregnancy. Pathology may be suspected on ultrasound scan where a linear echogenic substance is seen in the endometrium but diagnosis is confirmed by and treated with hysteroscopy. We present a case of a 43-year-old woman with 2 previous miscarriages who presented with secondary infertility. She had an ultrasound scan done which revealed features suggestive of an intra-uterine copper device. She subsequently had hysteroscopy and a bone-like foreign body was found in the endometrium which was removed with the aid of a grasper and later sent for histopathological evaluation for which a subsequent diagnosis of endometrial osseous metaplasia was made. Indeed, endometrial intraosseous metaplasia should be considered an important differential cause of secondary infertility especially in patients with history of previous miscarriage. Confirmatory diagnosis can be made through hysteroscopy and/or histopathologically although the former is now used.

Metaplasia ósea del endometrio. Reporte de un caso y revisión de la bibliografía / Endometrial osseous metaplasia. Case report and literatura review

RESUMEN La metaplasia ósea endometrial es una patología poco común que se asocia a infertilidad secundaria. La mayoría de casos se presenta en mujeres con antecedente de gestación no evolutiva. La sospecha se hace mediante el hallazgo de un endometrio hiperecogénico que se asemeja a la imagen de un dispositivo intrauterino. El gold standard para el diagnóstico y tratamiento es la histeroscopia con el estudio histopatológico del material obtenido en el pre-cedimeinto. La importancia de su descripción es su presentación en una paciente nuligesta. Se describe el caso clínico y revisión de la literatura. Palabras claves: Metaplasia ósea endometrial, infertilidad secundaria, endometrio hiperecogénico

ABSTRACT Endometrial osseoum metaplasia is a rare condition associated with secondary infertility. Most cases occur in women with a histo-ry of non-evolutionary pregnancy. The suspicion is made by the finding of a hyperechoic endometrium that is similar of an intrauterine de-vice. The diagnostic and therapeutic gold standard is made by hysteroscopy with histopathological study of the material obtained in the precedure. The importance of this case is its presentation in a nulliparous patient. The clinical case and literature review are described