Abstract
Objective
To describe clinical and demographic characteristics, ultrasound appearance, and hysteroscopic
outcomes of patients with endometrial osseous metaplasia.
Study design
We conducted a multicenter retrospective study. We retrospectively reviewed the medical
records of all consecutive patients who were referred for hysteroscopy at fourteen
institutions in Venezuela, Spain, Morocco, India, Ukraine, Argentina, the United States,
and Italy between 1994 and 2018. We identified and included all patients who had a
diagnosis of osseous metaplasia at the pathologic report, and data were retrieved
from the medical records.
Results
Between January 1st, 1994, and December 31st, 2018, 63 patients out of a total of
419,673 women who underwent hysteroscopy had a diagnosis of osseous metaplasia (0.015%).
Most patients were 31–40 years old (53.7%), were Caucasian or Hispanic (95.5%), and
had at least one previous pregnancy (86.9%). Forty-one out of 63 patients (65.1%)
had at least one miscarriage before the index hysteroscopy. Dysmenorrhea, abnormal
uterine bleeding, and infertility were reported by 34.9%, 27.0%, and 23.8% of patients.
14.3% of women were asymptomatic. Preoperative transvaginal ultrasound was available
and identified a hyperechoic area of variable size with posterior acoustic shadowing
in all cases. Hysteroscopy was successful without complications in all 63 cases. Follow-up
data were available in 30.2% of patients: 69.2% of patients were infertile, and 44.4%
of them conceived and achieved a live birth; all other symptoms improved after hysteroscopic
treatment in all patients.
Conclusions
Osseous metaplasia appears associated with multiple unspecific gynecologic symptoms
without the predominant role of infertility, as previously suggested. Although endometrial
osseous metaplasia is rare, gynecologists should consider this pathologic condition
when the characteristic ultrasound appearance is detected, being hysteroscopic treatment
effective.
Keywords
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Article info
Publication history
Published online: August 31, 2021
Accepted:
August 29,
2021
Received in revised form:
August 17,
2021
Received:
May 29,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
