Postmenopausal osseous metaplasia of the endometrium: An uncommon histopathological entity: A case report
Abstract
Endometrial osseous metaplasia is a rare histopathological condition characterized by the presence of ectopic bone tissue within the endometrium. Although most commonly reported in women of reproductive age presenting with secondary infertility and menstrual abnormalities, it may occasionally occur in asymptomatic postmenopausal women. A 55-year-old postmenopausal woman with a history of invasive ductal breast carcinoma treated with surgery, radiotherapy, chemotherapy and 10 years of tamoxifen therapy was referred for evaluation of incidentally detected endometrial thickening (12 mm) on routine ultrasonography. Transvaginal ultrasound demonstrated a suspected endometrial polyp with posterior acoustic shadowing. Diagnostic hysteroscopy revealed osseous tissue and bone marrow within the endometrial cavity, raising concern for carcinosarcoma or another mesenchymal malignancy. Following multidisciplinary tumour board discussion, operative hysteroscopy with resectoscopy was performed, confirming the presence of osseous tissue; however, malignancy could not be definitively excluded. The patient subsequently underwent total hysterectomy with bilateral salpingo-oophorectomy. Final histopathological examination demonstrated atrophic endometrium containing two microscopic foci of bony tissue with degenerative and necrotic changes, confirming endometrial osseous metaplasia without evidence of malignancy. Notably, the patient had undergone pharmacologically induced abortion followed by…
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