Bilateral massive osseous metaplasia in ovaries: “ovarian stones”

Abstract

We report a case of bilateral ovarian ossifications with images that mimic stone formations. A 65-year-old woman presented with a 2-year history of pelvic pain. Computed tomographic scan and pelvic ultrasound identified an enlarged uterus with two calcified lesions interpreted as leiomyomas. Surgical exploration revealed two ovaries with a cystic appearance and stony hard areas. The cyst contents consisted of chocolate-colored material. The pathologic findings were compatible with benign bilateral ovarian endometriotic cysts with extensive ossification. The pelvic pain resolved completely after the surgery. Though the cause of this rare case remains unknown, recognition of cysts with a content of chocolate-colored material and pigment-laden histiocytes allowed us to make the diagnosis of bilateral ovarian endometriotic cysts with extensive ossification. Complete excision was the treatment of choice.

Osseous Metaplasia in Ovarian Endometrial Cyst: A Case Report

“…BMPs upregulate expression of adhesion molecules promoting leukocyte adhesion, with consecutive chronic inflammation and tissue fibrosis [23]. The pathogenesis of osseous metaplasia in ovary is also uncertain, but it appears to be an unusual reaction to tissue damage and repair [24]. For some authors the possible explanation is overgrowth of coexisting coalesced psammomatous calcifications, which may arise from spontaneous or induced necrosis of the tissue [24].…”

“…The pathogenesis of osseous metaplasia in ovary is also uncertain, but it appears to be an unusual reaction to tissue damage and repair [24]. For some authors the possible explanation is overgrowth of coexisting coalesced psammomatous calcifications, which may arise from spontaneous or induced necrosis of the tissue [24]. For others they are related to secretion BMPs [24].…”

“…For some authors the possible explanation is overgrowth of coexisting coalesced psammomatous calcifications, which may arise from spontaneous or induced necrosis of the tissue [24]. For others they are related to secretion BMPs [24]. Bone morphogenetic protein (BMP) ligands are able to induce bone and cartilage development and are found to have a complex role in the embryonic development of many organ systems [25,26].…”

“…Overactive BMP signaling pathway is considered to be the underlying cause of the ectopic chondrogenesis, ectopic bone formation, and joint fusion seen in patients with Fibrodysplasia ossificans progressiva -FOP [25]. In this condition, ectopic bone is thought to originate from mesenchimal stem cells (MSCs) which lie dormant in soft tissues and differentiate into osteogenic cells [24].…”

Stromal Osseous Metaplasia in Ovarian Serous Cystadenocarcinoma

“…On the other hand ovarian ossifi cation also reported in non-neoplastic ovarian condition like endometriosis [5,6,[14][15][16] and simple follicular cyst with urogenital abnormality [17] .…”