Testicular calcification is caused by calcium deposits of the testis in men with controversial and unknown etiology. Calcifications with a size >3 mm are considered as macrocalcifications. Calcifications are the result of high local calcium concentrations in many tissues. Ultrasonography is the gold standard imaging tool for testis investigation. We report a 28-year-old man who presented with left testicular pain and an inguinal hernia from 1 year ago. The ultrasonography demonstrated a hypoechoic calcified region size of 12 × 18 mm. The tumor markers were negative. After radical orchiectomy, the histopathology showed testicular calcification with benign osseous metaplasia. Calcification within a testis is found incidentally using ultrasonography since it may be misdiagnosed as a small benign or malignant mass.

Osseous metaplasia (OM) of the cervix without involvement of the uterus is an extremely rare entity. Only few cases had been reported in the literature. We reported a rare case of OM of the cervix clinically mimicking cervical cancer. A 52-year-old female presented with chief complaints of leukorrhea and an unusual sensation of mass in the vagina. On clinical examination, the uterus, adnexa, pouch of Douglas, vulva, and perineum-all were normal except the cervix which was hypertrophied with surface irregularities. Histopathological examination of the cervix showed OM of the cervix. Since this is a benign entity, proper diagnosis is essential to avoid misdiagnosis of malignant tumors, especially malignant mesenchymal tumors.

Osseous metaplasia of the endometrium is a rare and intriguing pathological condition characterized by the presence of bony tissue within the endometrial cavity. This phenomenon can have significant clinical implications, particularly in the context of infertility. The etiology of osseous metaplasia remains unclear, although various hypotheses have been proposed, including chronic inflammation, dystrophic calcification, and residual embryonic tissue. Clinically, patients may present with secondary infertility, abnormal uterine bleeding, or pelvic pain. Diagnosis can be made based on ultrasonography and histopathological analysis of the endometrial tissue. Treatment typically involves the removal of the osseous tissue via hysteroscopy, which can lead to the restoration of normal endometrial function and potentially resolve infertility. Further research is needed to elucidate the etiological factors and optimize treatment protocols.

Rectal mucosal prolapse is uncommon in children. While most patients present with rectal bleeding and constipation, the occurrence of osseous metaplasia within the prolapsed mucosa is extremely rare. Overlapping clinical, gross, and histological features between rectal mucosal prolapse polyps and malignancy pose a challenge for diagnoses. We describe a case of a 16-year-old male who had a rectal mucosal prolapsed polyp with osseous metaplasia. He initially presented due to periumbilical pain with a sore throat and fever. Incidentally, during the workup of his periumbilical pain, he was found to have a soft tissue mass in his rectum on a CT scan, with a biopsy confirming the diagnosis. The case was complicated by the development of sepsis. The patient was treated with empiric antibiotics and was discharged without further complications.

Pulmonary osseous metaplasia is a disease in which mature bone is found within the parenchyma of the lung. The current study presents a case of pulmonary osseous metaplasia in a 64-year-old female. The patient was previously diagnosed with transitional cell carcinoma (TCC) of the lower ureter. During a routine check-up, an enhancing basal lung nodule was found on chest computed tomography scan, which was suspected to be metastatic lung disease. The patient underwent a thoracoscopic resection of the nodule. The histopathological examination of the specimen confirmed it to be myeloid osseous metaplasia. The disease usually has no significant complications and can also be found in association with other pulmonary diseases. Very limited information is available on the phenomenon; therefore, there is no exact treatment guide for clinicians to follow. In conclusion, myeloid osseous metaplasia of the lung is a rare finding, and based on this report, it may be associated with TCC.

BACKGROUND: Gastrointestinal stromal tumor is considered the most common mesenchymal neoplasm of the gastrointestinal tract. The majority of gastrointestinal stromal tumor cases are located in the stomach and usually affects older adults. Most of gastrointestinal stromal tumor cases are sporadic; however, few have a syndromic association, including Carney triad, Carney-Stratakis syndrome, familial gastrointestinal stromal tumor syndrome, and neurofibromatosis type 1.
METHODS: Herein, we report a rare case of a 54-year-old Middle-Eastern female with multifocal gastrointestinal stromal tumor mixed type (epithelioid and spindle cell type) with osseous metaplasia. Fluoresce in situ hybridization analysis of platelet-derived growth factor receptor alpha revealed deletion in 42% of the tumor cells studied. Interestingly, next generation sequencing revealed platelet-derived growth factor receptor alpha exon 12 mutation (p.Y555C) and exon 14 mutation (p.N659Y).
CONCLUSIONS: In conclusion, osseous metaplasia in GIST is a very rare event and only few cases are reported in the literature. The number of reported cases is inadequate to confirm the pathogenesis and the prognosis.

Background: Osseous tissue in the endometrium is a rare find, and it is most often discovered when the patient presents with infertility. It is frequently associated with dysmenorrhea and abnormal menstrual bleedings. Although its etiology remains unclear, in almost all described cases until now, the patient has an obstetrical history. Case report: In this report, we present a unique case of endometrial osseous metaplasia in a 27-year-old primary infertile patient. The transvaginal ultrasound revealed a 18/13/7 mm hyperechoic endometrial mass with posterior acoustic shadowing and no flow on color Doppler. A hysteroscopic examination found a polygonal calcification on the endometrial posterior face of the uterine cavity, in the corporeal isthmic region, which was extracted. The histopathological evaluation revealed microscopic elements compatible with endometrial calcification. The patient had a good postoperative course and the complex endocrinologic, immunologic and electrolytical investigation failed to prove any abnormality. Follow-up transvaginal ultrasound examinations revealed no modifications. Three years later, the patient conceived spontaneously, had an uneventful pregnancy and delivered a full-term fetus. Conclusion: We assumed that this entity can be a serious cause of infertility since the patient had a long history of (primary) infertility and its resection made the pregnancy\'s occurrence possible. Finally, since neither history of abortion or chronic inflammation nor any abnormal laboratory test were noticed, we concluded that the etiology of this entity remained unclear.

UNASSIGNED: Understanding the role of hormones in periodontitis is important. Periodontal microscopic surgery approach in the treatment of fibrous epulis is not indicated. Wider flap access with root planning is indicated to control the lesion in one phase.
UNASSIGNED: We present a case of a 40-year-old female who presented with a gingival hyperplastic lesion around the maxillary left permanent central and lateral incisors. Patient\'s medical history reveals a recent pregnancy, hypothyroidism, ulcerative colitis, and schizoaffective disorder. All medical conditions were controlled by medications. The lesion was excised using a minimally invasive periodontal surgical technique, and the biopsy results confirmed a diagnosis of ulcerative fibrous epulis with osseous metaplasia. No curettage or local debridement was done under the assumption that the patient\'s oral hygiene was satisfactory and due to aesthetic concerns of gingival recession and creation of black triangles. The lesion recurred after 3 months and was removed using a traditional more invasive surgical technique. The patient was followed up for 2 years, and there was no further recurrence due to the complete excision of the lesion in the second surgery and the disappearance of the hormonal-related factors post-pregnancy that could have contributed to the gingival hyperplasia. The unique component of the case we are presenting is the comparison between two different surgical techniques and the conduction versus absence of local periodontal debridement after surgical excision as well as the possible correlation between oral supplements and the calcific nature of the lesion(s) reported. The case we present demonstrates that a more invasive traditional surgical approach together with local periodontal therapy provide an optimum treatment outcome in conjunction with elimination of any associated etiological factors. We also propose that hormones are more important as an etiological factor in developing fibrous epulis lesions than medical conditions and medications.

UNASSIGNED: Neuroendocrine tumors are a rare finding in the gallbladder. The incidence of this entity in the gallbladder is roughly 1.13 cases per 100,000 in the US, with a steady increase in the last decade. Gallbladder neuroendocrine tumors are generally asymptomatic; the majority of cases have been reported as incidental findings in specimens, resected due to secondary symptomatology, such as chronic cholecystitis. Treatment strategies are limited, in part due to the often advanced stage in which this disease presents. Furthermore, there is a restricted utility of diagnostic tools for early detection; these factors contribute to the poor prognosis of this disease process.
UNASSIGNED: We describe a case of a gallbladder carcinoid tumor, incidentally found in a 78-year-old male patient who presented to the emergency room complaining of chronic intermittent right upper quadrant pain, accompanied by nausea and vomiting. A positive murphy sign was elicited on physical examination, which was otherwise unremarkable. An abdominal ultrasound showed an otherwise normal-appearing gallbladder except for a \"floating polyp\" with no suspicious radiologic features. A diagnosis of chronic cholecystitis was presumed, and the patient was taken to the operative room for laparoscopic cholecystectomy. Microscopic evaluation of the gallbladder specimen yielded a diagnosis of a well-differentiated neuroendocrine tumor and complex cholesterol polyps, in a setting of chronic cholecystitis.
UNASSIGNED: Neuroendocrine tumors of the gallbladder, a rare entity, are generally asymptomatic, with most cases diagnosed incidentally in gallbladder specimen resected for reasons other than suspected malignancy. Chronic inflammatory processes are seen to be related to the development of metaplasia and possibly the development of tumors of the neuroendocrine lineage. Based on a review of literature, we have found that no specific treatment approach, beyond surgical resection, is in place to manage patients with this condition. Formation of an expert committee to review and discuss guidelines for appropriate clinical monitoring, as well as consideration of a multi-site prospective registry is suggested.

Osseous metaplasia is an extremely rare occurrence in traditional serrated adenoma (TSA). We report a case of a 50-year-old female with a TSA with osseous metaplasia (OM). The adenoma was identified during a colonoscopy for endoscopic mucosal resection of a previously identified polyp. The polyp location was the rectum. The colonoscopy was negative for any signs of concurrent malignancy. This case report is the fifth case of OM in a TSA reported in English. The clinical significance of OM is uncertain, and there is limited literature describing these lesions.