Clinicopathological Insights Into Endometrial Osseous Metaplasia: A Rare Case Report

Endometrial osseous metaplasia is a rare entity encountered in the reproductive age group characterized by the presence of mature bone within the endometrium. Most of the cases are associated with secondary infertility, with a past history of abortion or chronic endometritis. Various hypotheses, such as chronic inflammation, dystrophic calcification, and residual embryonic tissue, have been proposed for the etiopathogenesis. Hysteroscopic removal of the osseous tissue leads to the restoration of normal endometrial function and can potentially resolve infertility. We present a case of a 36-year-old female presenting with abdominal pain. Ultrasonography was suggestive of dystrophic calcification in the endometrium. Bony fragments, along with endometrial curettage material, were removed by hysteroscopy. Histopathology revealed proliferative endometrial glands and stroma admixed with fragments of mature bony trabeculae. A diagnosis of endometrial osseous metaplasia was confirmed. This case report highlights the importance of correctly diagnosing this rare condition on histopathology and differentiating it from other mimics to guide appropriate treatment.