A Rare Case of Ovarian Cancer with Heterotopic Myositis Ossificans in Abdominal Muscles

Abstract

Background: Heterotopic ossification (HO) describes the abnormal development of mature bone within soft tissues where bone does not typically exist that is at sites other than the skeleton system. It is a benign condition that, although rare, can develop in the abdominal wall following prior surgical intervention or trauma. Due to its infrequent occurrence and the limited number of documented cases, its true incidence remains unclear.
Case Presentation: A forty one year old P2+1 (L2) was diagnosed with high grade serous ovarian cystadenocarcinoma Stage III C after laparotomy with omentectomy and ovarian biopsy. She received four cycles of neoadjuvant chemotherapy after which she underwent interval debulking surgery. Intra-operatively, a hard calcified bony structure was identified and removed through the planes of lower end of right rectus abdominus and both pyramidalis muscles. This was reported as myositis ossificans on histopathology due to evidence of mature lamellated bony tissue.
Conclusion: Our case highlights an uncommon presentation but a clinically significant manifestation of abdominal surgery. Establishing the diagnosis of HMO is critical as unnecessary investigations or over-treatment may have considerable consequences for the patients.