Endometriosis Stones in Ovary: A Case Report

Bone formation within ovarian lesions, such as endometriotic cysts and cystadenocarcinoma, is a rare clinical finding. This report documents the case of a 42-year-old woman presenting with chronic lower abdominal pain and a palpable left adnexal mass. Initial blood work was unremarkable; however, transvaginal ultrasonography identified a complex 29 mm × 32 mm cystic lesion containing solid components, leading to initial concerns regarding potential ovarian malignancy. The patient underwent an elective oophorectomy. Surgical exploration revealed an enlarged, pale ovary characterized by foci of endometriosis and the presence of two distinct stone-like fragments. Histological analysis subsequently confirmed the diagnosis of an endometrioma. Although the exact pathogenesis of ovarian ossification remains poorly understood and requires further investigation, this case highlights the necessity of surgical intervention for such masses. Importantly, clinicians should remain aware that despite the concerning appearance of ossified adnexal structures, they may ultimately prove to be benign entities.