Abstract：
Osseous metaplasia of the endometrium is a rare entity in which there is presence of mature or immature bone tissue in the endometrium. It is a rare disorder that usually leads to secondary infertility and is frequently associated with recurrent miscarriages and can be rarely asymptomatic. We present the case of a patient with endometrial ossification associated with secondary infertility. The patient presented with excessive vaginal discharge and was undergoing evaluation for secondary infertility. Transvaginal sonography showed a hyperechoic elongated lesion in the endometrium suggestive of endometrial calcification with posterior acoustic shadowing. Diagnostic hysteroscopy was done and the endometrial cavity showed multiple white-colored, solid, fan-shaped structures and bony spicules all over the endometrium, which were removed with a hysteroscopic grasper and sent for histopathological examination (HPE). The HPE confirmed the presence of bony trabeculae along with secretory endometrial glands. There have only been a few cases of endometrial osseous metaplasia reported in India and it is usually an overlooked cause of infertility. Although rare, we should consider this as a probable cause of secondary infertility when the characteristic ultrasound features are visualized and that hysteroscopic resection is the gold standard treatment.
摘要：
子宫内膜的骨化生是一种罕见的实体，其中子宫内膜中存在成熟或未成熟的骨组织。这是一种罕见的疾病，通常会导致继发性不孕，并经常与复发性流产有关，很少无症状。我们介绍了一例子宫内膜骨化与继发性不孕症相关的患者。该患者出现过多的阴道分泌物，正在接受继发性不孕症的评估。经阴道超声检查显示子宫内膜有高回声细长病变，提示子宫内膜钙化并伴有后声阴影。进行诊断性宫腔镜检查，子宫内膜腔显示多个白色，固体,子宫内膜上的扇形结构和骨状针状突起，用宫腔镜抓紧器取出并送去组织病理学检查（HPE）。HPE证实存在骨小梁以及分泌子宫内膜腺。在印度，只有少数病例报道了子宫内膜骨化生，这通常是不孕的一个被忽视的原因。虽然罕见，当特征性的超声特征可视化并且宫腔镜切除术是黄金标准治疗时，我们应该将其视为继发性不孕的可能原因。
