Department of Histopathology, Babcock University Teaching Hospital, Ilisan-Remo, Ogun State, Nigeria.
Department of Obstetrics and Gynecology, Babcock University Teaching Hospital, Ilisan-Remo, Ogun State, Nigeria.
Pan Afr Med J. 2021 Sep 28;40:61. doi: 10.11604/pamj.2021.40.61.30691. eCollection 2021.
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.
子宫内膜骨化生是一种罕见的疾病，其特征是子宫内膜中存在异常的骨组织。在非洲，这种病理情况的报道病例很少，通常被忽视为不孕的原因。发病机制尚不清楚，但大多发生在妊娠后。病理学可能在超声扫描中被怀疑，在超声扫描中可以看到子宫内膜中的线性回声物质，但诊断是通过宫腔镜检查来确认和治疗。我们介绍了一个 43 岁的妇女，她有 2 次自然流产史，表现为继发性不孕。她做了超声检查，结果显示宫内有宫内铜装置的特征。随后进行了宫腔镜检查，发现子宫内膜中有一个类似骨头的异物，用抓钳将其取出，随后进行组织病理学评估，随后诊断为子宫内膜骨化生。事实上，子宫内膜骨化生应该被认为是继发性不孕的一个重要鉴别原因，特别是在有自然流产史的患者中。通过宫腔镜检查和/或组织病理学检查可以做出明确诊断，尽管前者现在已被广泛应用。
