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Annals of Medicine and Surgery (2012) May 2023Little is known about the rare condition, osseous metaplasia of the uterus, with few cases described worldwide. It is a non-neoplastic transformation in which...
UNLABELLED
Little is known about the rare condition, osseous metaplasia of the uterus, with few cases described worldwide. It is a non-neoplastic transformation in which endometrial stroma is replaced with a mix of bone and cartilage. Occurring commonly after pregnancy, it is thought that the persistence of foetal embryonic remnants contributes to this change. If untreated, osseous metaplasia of the uterus can have a major impact on a woman's fertility.
CASE PRESENTATION
The authors present a case of a woman with the feeling of a foreign body in the vagina and a long-standing history of secondary infertility of unknown cause. She was found to have osseous metaplasia of the uterus with spontaneous expulsion of the bony fragments from the uterus into the cervical canal, creating the sensation of foreign body in the vagina. She was treated with hysteroscopic resection. Fertility returned 3 months post procedure.
CLINICAL DISCUSSION
This case provides a valuable reminder that osseous metaplasia can have a varied clinical presentation and requires a careful history and examination.
CONCLUSION
This case reinforces the importance of a thorough diagnostic assessment in the woman presenting with foreign body in the vagina/cervix and /orsecondary infertility. This rare but important diagnosis can have a lasting impact on a woman's reproductive health if left untreated.
PubMed: 37229080
DOI: 10.1097/MS9.0000000000000583 -
International Journal of Fertility &... 2016To provide a comprehensive review of the published literature of patients with endo- metrial bone or osseous fragments with a view to critically examine the antecedent... (Review)
Review
To provide a comprehensive review of the published literature of patients with endo- metrial bone or osseous fragments with a view to critically examine the antecedent clinical presentation, investigations and prognosis after treatment. This systematic review of the literature includes full text articles of published case re- ports and cases series from the following computerized databases: PubMed, Ovid, and Medline between 1928 and 2013. We reviewed a total of 293 patients in 155 case reports and case series. The mean ± SD age at presentation was 32.7 ± 8.9. Approximately 88% of patients had at least one prior surgical uterine evacuation relating to pregnancy termina- tion or loss at a median gestational age of 14 weeks (range of 4-41 weeks). The most common presenting symptom was infertility (56.2%). One hundred twenty- four (66.0%) of the 188 patients attempting pregnancy after treatment achieved pregnancy prior to article publication and the majority (82.3%) were spontane- ous. Spontaneous miscarriage rate remains high (43%); however, most pregnancies ended in live-birth (55%). Bone fragments in the endometrium are most commonly found after pregnancy termina- tion, present with infertility and/or irregular menses, and upon removal, patients rapidly conceive spontaneously.
PubMed: 27441047
DOI: 10.22074/ijfs.2016.4904 -
Journal of Clinical Imaging Science 2018A case of left distal forearm and wrist osteolipoma in a 56 year old female is reported. The patient presented with a 3 year history of nontender left wrist mass....
A case of left distal forearm and wrist osteolipoma in a 56 year old female is reported. The patient presented with a 3 year history of nontender left wrist mass. Radiographs demonstrated a lobulated mass of mixed low density and calcifications, not adjacent to and with no connection to underlying bone. Ultrasound showed a spheroid hyperechoic lesion with internal heterogeneity and rim of calcifications. Magnetic resonance imaging revealed a lesion with predominantly fat characteristics on T1 weighted and T2 weighted sequences, with rim of peripheral calcification and specks of internal calcification. Histological examination after excision of the mass showed the lesion to be an osteolipoma. Osteolipoma is a rare variant of lipoma with osseous metaplasia and should be considered in the differential of a fat containing mass with ossification.
PubMed: 29862130
DOI: 10.4103/jcis.JCIS_80_17 -
Gynecology and Minimally Invasive... 2022Osseous metaplasia of the endometrium is defined by the presence of mature or immature bone tissue in the endometrium. Most of the cases are associated with secondary...
Osseous metaplasia of the endometrium is defined by the presence of mature or immature bone tissue in the endometrium. Most of the cases are associated with secondary infertility after abortion, chronic endometritis, or the presence of foreign bodies in the endometrium. Some cases are asymptomatic; others have menstrual abnormalities such as menorrhagia or oligomenorrhea. Osseous metaplasia is mostly seen after recurrent abortions. Removing the bone tissue helps spontaneous conception. Intrauterine hyperechogenic lesion, suggesting calcification in transvaginal ultrasonography, creates suspicion in diagnosis. Here, we present a patient who underwent dilatation and curettage procedure following a missed abortion, and osseous metaplasia of endometrium was radiologically detected at a 1-month follow-up examination. White bony material was shown in the uterine cavity with hysteroscopy. The lesion was treated by hysteroscopic removal without any complications. Histology confirmed the diagnosis of endometrial osseous metaplasia. Thus, hysteroscopy was effective in the diagnosis and treatment of endometrial osseous metaplasia.
PubMed: 36660327
DOI: 10.4103/gmit.gmit_121_21 -
CMAJ : Canadian Medical Association... Jun 2022
Topics: Calcinosis; Endometrium; Female; Humans; Infertility; Metaplasia
PubMed: 35760426
DOI: 10.1503/cmaj.220183 -
Oncotarget Sep 2017Osseous metaplasia (OM) is rarely observed in colorectal cancer (incidence < 0.4% in rectal cancer), where it has a non-specific clinical presentation and unknown...
Osseous metaplasia (OM) is rarely observed in colorectal cancer (incidence < 0.4% in rectal cancer), where it has a non-specific clinical presentation and unknown pathogenesis. Here, we report three cases of colorectal carcinoma with OM and propose a new hypothesis. All three patients (two males and one female) were Chinese and had different sites of colorectal carcinoma with OM: rectum, sigmoid colon, and appendix. The pathologic diagnoses were serrated adenocarcinoma; moderately to poorly differentiated adenocarcinoma with micropapillary carcinoma and cribriform comedo-type adenocarcinoma; and mucinous adenocarcinoma, respectively. Clinical follow-up showed that one patient died 5 months after surgery, but the others are alive after 68 months and 53 months. Immunohistochemistry revealed that CD44, MAPK, MDM2, OPN and PEDF were expressed by both tumor cells and stromal cells, while P53 was expressed only by tumor cells. KRAS/NRAS/BRAF genotyping revealed different KRAS mutations in each of the three cases, but the NRAS and BRAF exons were all wild-type. These findings suggest OM has no relation with NRAS and BRAF mutation, and it is uncertain whether there is a relationship between ossification and KRAS mutation. OPN, MAPK, MDM2, P53, PEDF and CD44 may act as osteogenic factors in colorectal cancer with OM.
PubMed: 29029440
DOI: 10.18632/oncotarget.18577 -
Journal of Korean Neurosurgical Society Dec 2013Ossified lipoma or osteolipoma are rarely reported. It is defined as a histologic variant of lipoma that has undergone osseous metaplasia. Osteolipoma presents with a...
Ossified lipoma or osteolipoma are rarely reported. It is defined as a histologic variant of lipoma that has undergone osseous metaplasia. Osteolipoma presents with a dominant osseous component within a lipoma. We report a case of a histologically confirmed osteolipoma on the nuchal ligament independent of bone. The patient was a 51-year-old female who presented with a 5-year history of a painless, progressively enlarging mass on the posterior neck. Computed tomography and magnetic resonance imaging showed a circumscribed mass compatible with fat between the C2 and C6 spinous processes with a large calcified irregular component. The mass with dual components was totally removed under general anesthesia and no recurrence was observed after 6 months of follow-up. We also reviewed the clinicopathologic features of previously reported osteolipomas in the literature and suggest that although osteolipoma is a rare variant of lipoma, it should be considered in the differential diagnosis when a lipoma of the posterior neck mixed with a bony component is encountered.
PubMed: 24527197
DOI: 10.3340/jkns.2013.54.6.518 -
Eplasty 2017Lipomas are very common benign tumors located in any part of the body in which fat is normally present, but lipomas containing both osseous and cartilaginous elements...
Lipomas are very common benign tumors located in any part of the body in which fat is normally present, but lipomas containing both osseous and cartilaginous elements are rare. A case of osteochondrolipoma in a 72-year-old man is reported. The tumor in the mental region was 2×1.5×1.5 cm. After resection of the tumor, there has been no recurrence during the 6-month postoperative follow-up. Histological examination confirmed the definitive diagnosis. Osteochondrolipoma is an extremely unusual lesion that should be kept in mind in the differential diagnosis of soft-tissue tumors.
PubMed: 29238440
DOI: No ID Found -
Fertility and Sterility Nov 2004To discuss, through the experience of a case report and extensive literature review, the best practices for the diagnosis and treatment of osseous metaplasia, which is... (Review)
Review
OBJECTIVE
To discuss, through the experience of a case report and extensive literature review, the best practices for the diagnosis and treatment of osseous metaplasia, which is the cause of secondary infertility.
DESIGN
Case report.
SETTING
In vitro fertilization unit in Athens.
PATIENT(S)
A 40-year-old woman with a 10-year history of secondary infertility.
INTERVENTION(S)
Hysteroscopic diagnosis and removal of the bony fragment.
MAIN OUTCOME MEASURE(S)
Elimination of secondary infertility caused by osseous metaplasia.
RESULT(S)
After treatment, the woman underwent an IVF program and a healthy neonate was born with cesarean section.
CONCLUSION(S)
Hysteroscopy remains the best practice for the diagnosis and removal of endometrial ossifications, causing secondary infertility.
Topics: Adult; Endometrium; Female; Fertilization in Vitro; Humans; Infant, Newborn; Infertility, Female; Metaplasia; Ossification, Heterotopic; Postoperative Period; Pregnancy; Uterine Diseases
PubMed: 15533373
DOI: 10.1016/j.fertnstert.2004.04.055 -
ACS Applied Bio Materials Jan 2022Craniofacial tissue injuries, diseases, and defects, including those within bone, dental, and periodontal tissues and salivary glands, impact an estimated 1 billion... (Review)
Review
Craniofacial tissue injuries, diseases, and defects, including those within bone, dental, and periodontal tissues and salivary glands, impact an estimated 1 billion patients globally. Craniofacial tissue dysfunction significantly reduces quality of life, and successful repair of damaged tissues remains a significant challenge. Blood vessels and nerves are colocalized within craniofacial tissues and act synergistically during tissue regeneration. Therefore, the success of craniofacial regenerative approaches is predicated on successful recruitment, regeneration, or integration of both vascularization and innervation. Tissue engineering strategies have been widely used to encourage vascularization and, more recently, to improve innervation through host tissue recruitment or prevascularization/innervation of engineered tissues. However, current scaffold designs and cell or growth factor delivery approaches often fail to synergistically coordinate both vascularization and innervation to orchestrate successful tissue regeneration. Additionally, tissue engineering approaches are typically investigated separately for vascularization and innervation. Since both tissues act in concert to improve craniofacial tissue regeneration outcomes, a revised approach for development of engineered materials is required. This review aims to provide an overview of neurovascularization in craniofacial tissues and strategies to target either process thus far. Finally, key design principles are described for engineering approaches that will support both vascularization and innervation for successful craniofacial tissue regeneration.
Topics: Bone and Bones; Humans; Neovascularization, Pathologic; Quality of Life; Tissue Engineering; Wound Healing
PubMed: 35014834
DOI: 10.1021/acsabm.1c00979