PULMONARY HETEROTOPIC OSSIFICATION; A RARE CAUSE OF MASSIVE HEMOPTYSIS

Introduction: Heterotopic ossification refers to bone formation in soft tissues, and its presence in non-skeletal organs is rare. Pulmonary heterotopic ossification (PHO) is an unusual condition, increasingly detected with the widespread use of computed tomography. PHO is often associated with tuberculosis and pulmonary tumors. Case Report: We present a male patient with a history of tuberculosis who developed massive hemoptysis. Imaging revealed a nodule in the left upper lobe, and the patient underwent a diagnostic and therapeutic Culmen resection (lingula-sparing S1–3 segmentectomy). Postoperatively, his symptoms resolved, and histopathology confirmed PHO. Conclusion: Diagnosis of PHO relies on histopathological evaluation, although chest X-ray and computed tomography provide initial clues. Massive hemoptysis, defined as ≥600 mL in 24 hours or ≥100 mL per hour, requires surgical intervention. In patients with hemoptysis and radiologic ossification or calcification, PHO should be considered. To our knowledge, coexistence of massive hemoptysis and PHO has not been reported, highlighting the rarity and clinical importance of this case.