CanSAGE 2022 | 59 – The Bare Bones of Endometrial Osseous Metaplasia
In this video, we present the case of a healthy 39 year-old with a known history of endometriosis who presented with menstrual irregularities and chronic pelvic pain. An advanced transvaginal ultrasound demonstrated echogenic linearities predominantly within the uterine cavity with extension into the myometrium. Previous uterine instrumentation history includes two early pregnancies treated by D&C as well as two prior IUDs that were had been previously removed. Endometrial biopsy revealed sampling of normal endometrial tissue. Operative hysteroscopy was performed with findings of osseous trabecular tissue embedded within the myometrium This uncommon pathologic entity is important to recognize as a potential cause for chronic pelvic pain, menstrual irregularities and fertility issues. Appropriate detection with ultrasound first-line can help to increase suspicion of this phenomenon. Ultimate investigation via hysteroscopic removal of abnormal tissue with sampling of the underlying endomyometrium is necessary for diagnosis and treatment of symptoms.