Osseous metaplasia of the uterus: an interesting presenting complaint and case of secondary infertility: case report.

Little is known about the rare condition, osseous metaplasia of the uterus, with few cases described worldwide. It is a non-neoplastic transformation in which endometrial stroma is replaced with a mix of bone and cartilage. Occurring commonly after pregnancy, it is thought that the persistence of foetal embryonic remnants contributes to this change. If untreated, osseous metaplasia of the uterus can have a major impact on a woman's fertility. Case presentation: The authors present a case of a woman with the feeling of a foreign body in the vagina and a long-standing history of secondary infertility of unknown cause. She was found to have osseous metaplasia of the uterus with spontaneous expulsion of the bony fragments from the uterus into the cervical canal, creating the sensation of foreign body in the vagina. She was treated with hysteroscopic resection. Fertility returned 3 months post procedure. Clinical discussion: This case provides a valuable reminder that osseous metaplasia can have a varied clinical presentation and requires a careful history and examination. Conclusion: This case reinforces the importance of a thorough diagnostic assessment in the woman presenting with foreign body in the vagina/cervix and /orsecondary infertility. This rare but important diagnosis can have a lasting impact on a woman's reproductive health if left untreated.

Seborrheic Keratosis-Like Lesion of the Cervix: First Report of the Cytological Features of a Low-Risk HPV 42-Associated Lesion.

INTRODUCTION: Seborrheic keratosis-like lesion of the cervix and vagina is a rare lesion and shows similar morphology to vulvar seborrheic keratosis; 3 of the 7 previously reported cases were associated with low-risk human papillomavirus (HPV) type 42. We report a case of seborrheic keratosis-like lesion of the cervix and provide the first description of the cytological features of this lesion. CASE PRESENTATION: A woman in her late forties presented with postcoital bleeding. She had a cervical screening test following which she underwent cervical biopsy, endocervical and endometrial curettage, large loop excision of the transformation zone of the cervix, and hysterectomy. RESULTS: The liquid-based cytology preparation showed cohesive groups of mildly atypical squamoid cells with a spindle cell morphology, mildly increased nuclear to cytoplasmic ratio, prominent nucleoli, and occasional nuclear grooves. No koilocytes were identified. Molecular genotyping revealed positivity for HPV type 42. DISCUSSION/CONCLUSION: This represents the first description of the cytological features of a seborrheic keratosis-like lesion of the cervix, which are distinctive and unusual. Whilst the mild squamous atypia raised the possibility of a low-grade squamous intraepithelial lesion, no koilocytes were identified. The association in our case with a low-risk HPV type, HPV 42, provides further evidence for a role of this HPV type in the pathogenesis of these lesions.