{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T18:05:22Z","timestamp":1786903522518,"version":"build-2736575974"},"reference-count":21,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T00:00:00Z","timestamp":1696896000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>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\u2019s 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.<\/jats:p>","DOI":"10.3390\/medicina59101803","type":"journal-article","created":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T06:14:04Z","timestamp":1696918444000},"page":"1803","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Endometrial Osseous Metaplasia\u2014A Rare Cause of Infertility with Unknown Etiology"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9000-4731","authenticated-orcid":false,"given":"Vlad Iustin","family":"Tica","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, \u201cSaint Andrew\u201d University Emergency Hospital Constanta, Faculty of Medicine, Academy of Romanian Scientists University \u201cOvidius\u201d, 900527 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iulia","family":"Postolache","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, Euromaterna Hospital, 900402 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madalina","family":"Bo\u0219oteanu","sequence":"additional","affiliation":[{"name":"Department of Pathology of \u201cSaint Andrew\u201d University Emergency Hospital Constanta, Faculty of Medicine, University \u201cOvidius\u201d, 900527 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Aschie","sequence":"additional","affiliation":[{"name":"Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Faculty of Medicine, University \u201cOvidius\u201d, 900591 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Tica","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine of \u201cSaint Andrew\u201d University Emergency Hospital Constanta, Faculty of Medicine, University \u201cOvidius\u201d, 900470 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8039-3200","authenticated-orcid":false,"given":"Cristian Ionut","family":"Orasanu","sequence":"additional","affiliation":[{"name":"Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, Faculty of Medicine, University \u201cOvidius\u201d, 900591 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana Cleopatra","family":"Penciu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, \u201cSaint Andrew\u201d University Emergency Hospital Constanta, Faculty of Medicine, Academy of Romanian Scientists University \u201cOvidius\u201d, 900527 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei Adrian","family":"Tica","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, University of Medicine and Pharmacy, 200349 Craiova, Romania"},{"name":"Department of Obstetrics and Gynecology, County Emergency Hospital, 200642 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliana","family":"Steriu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, \u201cSaint Andrew\u201d University Emergency Hospital Constanta, Faculty of Medicine, Academy of Romanian Scientists University \u201cOvidius\u201d, 900527 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudy Leon","family":"De Wilde","sequence":"additional","affiliation":[{"name":"\u201cPius\u201d Hospital Oldenburg, University Hospital for Gynecology, Carl von Ossietzky University Oldenburg, 26129 Oldenburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oana Sorina","family":"Tica","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, County Emergency Hospital, 200642 Craiova, Romania"},{"name":"Department of Obstetrics and Gynecology, University of Medicine and Pharmacy, 200642 Craiova, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/s43043-020-00045-0","article-title":"Imaging of endometrial osseous metaplasia\u2014An uncommon but treatable cause of infertility","volume":"25","author":"Wani","year":"2020","journal-title":"Middle East. 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