Abstract :

Introduction: Endometrial ossification is a rare condition in which its actual etiology and pathogenesis is controversial and debatable however, the condition is usually related to secondary infertility after abortion and endometritis.

Case presentation: A 32-year-old para 2 living 1 lady who presented with long-standing intermittent sharp pelvic pain for seven years. She was a self-referral to BMC gynecology outpatient unit due to chronic pelvic pain. No prior history of intrauterine copper device insertion. Upon evaluation, she had normal ovulatory cycles. A pelvic x-ray could not show any spine deformities or any pelvic abnormalities. During transabdominal pelvic ultrasound imaging, a well-defined thick linear hyperechogenic structure with acoustic shadowing was seen in the endometrial cavity measuring 2 x 3 cm aligned to endometrial strips. Ultrasound guided sharp dilatation & curettage (D&C) was performed by using ovum forceps in which we successfully removed a tubular structure measuring 2.3 by 3.4 cm with sharp ends deep in the endometrium. Histopathological analysis revealed trabecula and extracellular matrix osteocytes in keeping with endometrial ossification.

Conclusion: Endometrial ossification can be effectively treated with ultrasound guided dilation and curettage as an alternative to hysteroscopy.