Background: Heterotopic ossification is the formation of bone in tissues outside the skeletal system. Ectopic bone in a midline laparotomy scar is usually asymptomatic.
Case description: A 59-year-old man was referred by his GP to the surgical outpatient clinic because of dull epigastric pain along with a painful swelling. He had undergone a midline laparotomy 6 months earlier. A CT scan revealed a longitudinal ossification of 9 cm in length, extending from the xyphoid process to the umbilicus. The structure was excised because of progressive symptoms. The diagnosis of heterotopic ossification was confirmed by histopathology.
Conclusion: This case describes the clinical and histopathological presentation of heterotopic ossification in a laparotomy scar. Current insights and the pathophysiology of this condition are reviewed. Treatment is only indicated in symptomatic patients, and consists of surgical excision.