Endometrial ossification successfully treated by hysteroscopic resection

Torné, Aureli; Jou, P.; Pagano, Rafael; Sánchez, Ignacio; Ordi, Jaume; Vanrell, Juan A.

doi:10.1016/0301-2115(95)02376-3

Cited by 29 publications

(19 citation statements)

References 3 publications

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“…However, the effective participation of these pathogenic mechanisms to metaplastic transformation remains hypothetical [9].…”

Section: Discussionmentioning

confidence: 99%

Endoscopy Management of Endometrial Ossification Associated With Secondary Infertility: A Case Report and Review of Literature

Horo¹,

Aka²,

Toure³

et al. 2016

J Clin Gynecol Obstet

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The osseous metaplasia of the endometrium is a rare disease. It is very often discovered incidentally during the balance sheet infertility in women. The lesion is suspected in an ultrasound, a hysterosalpingography or a hysteroscanner. However, the diagnosis and treatment are done with hysteroscopy. It is either secondary to an abortion with persistence of fetal bone or due to a true osseous metaplasia of endometrial tissue. We report a case of a patient diagnosed with bone metaplasia in hysteroscanner and treated with hysteroscopy. The patient contracted a spontaneous pregnancy 12 months later, which resulted in the birth of a living child weighing 3,000 g.

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“…However, the effective participation of these pathogenic mechanisms to metaplastic transformation remains hypothetical [9].…”

Section: Discussionmentioning

confidence: 99%

Endoscopy Management of Endometrial Ossification Associated With Secondary Infertility: A Case Report and Review of Literature

Horo¹,

Aka²,

Toure³

et al. 2016

J Clin Gynecol Obstet

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“…One possible mechanism is that retention of fetal bones secondarily promote osteogenesis in the surrounding endometrium. Fetal bones may supply a source of calcium for ossifi cation [6]. Another mechanism is that implantation of embryonic parts without pre-existing bone after early stage abortions induces endometrial osseous metaplasia.…”

Section: Discussionmentioning

confidence: 99%

A case of endometrial osseous metaplasia treated by hysteroscopic operation

Lee

Kwon

et al. 2012

Korean J Obstet Gynecol

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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 fi rst 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 calcifi cation. 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. Keywords: Osseous metaplasia; Hysteroscopy; Secondary infertility Copyright © 2012. Korean Society of Obstetrics and GynecologyOsseous metaplasia is a very rare disorder of endometrium that usually leads to secondary infertility. Endometrial ossification is frequently associated with a history of recurrent abortions. Its clinical presentation may include vaginal bleeding or discharge, menometrorrhagia, dysmenorrhea, and pelvic pain [1]. Although the etiology of this rare condition is unknown, the most widely accepted hypothesis is that ossification is related to retained fetal bones, following abortion suggesting endochondral ossifi cation. It also may be related to transformation of mesenchymal tissue to osseous tissue in response to infl ammation and the reparative process induced by abortion. Some cases of endometrial ossifi cation arise after abortion at an early age of gestation or even without abortion, suggesting a phenomenon of true heterotopias with metaplasia of mature endometrial stromal cells [2]. In this report, we present a patient with endometrial osseous metaplasia after previous termination of pregnancy. To our knowledge, this is the second case that the patient was successfully treated by hysteroscopic operation in Korea. Case ReportA 42-year-old woman, a North Korean defector, visited our hospital to take health gynecological screening. She fled from the North to South Korea a year ago. She had menarche at the age of 13 years followed by regular menstrual cycles. She had no history of endocrine abnormalities. Her obstetric history was notable for two pregnancies. Both of which were electively terminated in a medical facility of North Korea. Her fi rst pregnancy was a vaginal delivery at about 20 weeks of gestation 16 years ago. Her second pregnancy showed dilatation and curettage at about 14 weeks of gestation 14 years ago. She has been infertile and failed to conceive since then. She had a regular menstrual cycle and had no CASE REPORT Korean J Obstet Gynecol 2012;55(5):361-365 http://dx

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“…Este procedimiento, a diferencia de la histeroscopía diagnostica o quirúrgica para resección de pólipos o miomas submucosos, no se beneficia de la preparación endometrial con anticonceptivos o uso de análogos de GNRH, debido a la escasa proliferación endometrial presente en estos casos [3][4][5][6][7][8][9][10][13][14][15][16][17][20][21][22][26][27][28][29] .…”

Section: Discussionunclassified

Extensa metaplasia ósea endometrial y exitoso embarazo espontáneo post tratamiento

2010

Rev. méd. Chile

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Bony metaplasia of the endometrium. Report of two casesWe report a 28-year-old female consulting for infertility and a 26-year-old woman consulting for severe dysmenorrhea. In both patients a osseous metaplasia of the endometrium was found. Both patients were subjected to a hysteroscopic resection of the osseous material and both achieved spontaneous pregnancies and term deliveries following the procedures. If the bony material is removed, normal pregnancies and deliveries are feasible afterwards, no matter how extensive is the the osseus metaplasia. (Rev Med Chile 2010; 138: 1004-1007 a metaplasia ósea endometrial corresponde a la presencia de tejido óseo en el interior de la cavidad uterina. Es una patología de baja incidencia (0,3 x 1.000 mujeres) y en 80% de los casos existe el antecedente de abortos espontáneos o inducidos, generalmente de 12 semanas o más de gestación. No existe una teoría con respecto a su etiología, sin embargo, se han formulado múltiples hipótesis al respecto .Clínicamente se presenta con metrorragia, dismenorrea, algia pélvica y flujo vaginal en ocasiones con restos óseos. También se ha asociado a infertilidad primaria y secundaria, especulándose que el tejido óseo podría ejercer una acción similar a un dispositivo intrauterino 4-10 .Comunicamos el caso de dos pacientes con diagnóstico de metaplasia ósea extensa endometrial, dado el compromiso completo de la cavidad, que fueron sometidas a resectoscopía, logrando posteriormente un embarazo espontáneo. Caso clínico 1Paciente de 28 años, multípara de uno, con antecedente de parto vaginal a término con resultado de mortineonato por sepsis (Staphylococcus aureus). Consultó el año 1999 por deseo de embarazo luego de tres años de exposición. Dentro del estudio, destacaba una ecografía transvaginal que sugería el diagnóstico de metaplasia ósea al visualizarse una intensa ecorrefringencia de toda la zona endometrial.Se programó una resección histeroscópica en la cual se extrajo abundante tejido osificado, cuya anatomía patológica confirmó el diagnóstico de metaplasia, sin embargo, no fue posible extraer todos los fragmentos en una primera instancia por motivos de seguridad para la paciente (prolongado procedimiento con mayor exposición peritoneal a glicina, sangrado miometrial, riesgo de perforación, etc.). Recibió estrógenos conjugados 3,75 mg diarios por un mes, seguido de anticonceptivos orales cíclicos con 50 µg de etinilestradiol. Se realizó una segunda resectoscopía seis meses más tarde para extraer el tejido metaplásico remanente, realizándose exitosamente.Se embarazó espontáneamente al año de exposición, evolucionando sin incidentes. A las 38 semanas de gestación se obtuvo un recién nacido sano de 3.560 g por cesárea tras prueba de trabajo de parto fracasada (Figura 1).

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Endometrial ossification successfully treated by hysteroscopic resection

Cited by 29 publications

References 3 publications

Endoscopy Management of Endometrial Ossification Associated With Secondary Infertility: A Case Report and Review of Literature

Endoscopy Management of Endometrial Ossification Associated With Secondary Infertility: A Case Report and Review of Literature

A case of endometrial osseous metaplasia treated by hysteroscopic operation

Extensa metaplasia ósea endometrial y exitoso embarazo espontáneo post tratamiento

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