Endometrial osseous metaplasia is a very rare disease related to secondary infertility. A 42-year-old woman, a North Korean defector, visited for gynecological exam. She presented with a history of secondary infertility. She had two previous pregnancies and both were voluntarily terminated at 14 and 16 years ago. Vaginal delivery at about 20 weeks in the fi rst gestation 16 years ago; and dilatation and curettage at about 14 weeks 14 years ago were done in a medical facility of North Korea. Vaginal ultrasonography showed an intrauterine structure described as a hyperechogenic image suggesting calcifi cation. Hysteroscopy revealed multiple coral-like white spicules about 1 cm in length in the uterine cavity. The lesion was treated by hysteroscopic removal without complications. Histology established the diagnosis of endometrial osseous. In our case, hysteroscopy was effective in the diagnosis and treatment of endometrial osseous metaplasia.
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