Skeletal metastatic carcinoma: A case from 15th–20th century Coimbra,Portugal

This paper discusses the differential diagnosis of unusual and distinct pathological changes in the skeletal remains of a 40+‐year‐old female from 15th–20th century Coimbra (Portugal). The most affected area seems to have been the skull, but multiple lesions, lytic and/or blastic, have been found throughout the post‐cranial skeleton, more specifically in the scapulae, clavicles, humerus, sternum, ribs, sacrum, innominates and femurs. The differential diagnosis of the lesions gave rise to several possible pathological conditions, namely, Langerhans cell histiocytosis (granulomatosis or Histiocytosis X), multiple myeloma and metastatic carcinoma. Various macroscopic and radiological aspects lead us to consider metastatic carcinoma as the most probable diagnosis. Despite the argumentative identity of the possible primary lesion, age, sex and the mixed nature of the osseous response are consistent with cancer of the breast but do not exclude other carcinomas, namely lung cancer. With temporal and regional differences emerging in the frequency of malignant tumours, the identification of new cases becomes important, particularly from geographic areas where few cases have been reported. In fact, the present report adds to the only case of metastatic carcinoma detected in non‐identified Portuguese human skeletal remains until now. Copyright © 2009 John Wiley & Sons, Ltd.     

Metastatic carcinoma in a 14th–19th century skeleton from Constância (Portugal)

During 2002, the extensive archaeological excavations of the ancient Constância necropolis (Centre of Portugal), dated from 14th–19th centuries, resulted in the exhumation of 151 individuals. Among the several paleopathological cases, a middle‐aged female skeleton with osteolytic lesions in her skull, axial skeleton, upper limbs and femurs was observed. These pathological findings are characterised by an asymmetric pattern with osteolytic focus of distinct size and irregular shape. Some skeletal elements display both osteolytic and osteoblastic lesions. The latter exhibit deposition of fine layers of woven bone. Lesions were observed macroscopically and radiology was used as a complementary method of scrutiny, especially in cases of unclear observation. The case was diagnosed as that of a probable metastatic carcinoma due to the multifocal distribution of the lesions in areas of intense haematopoietic activity, their morphology and some osteoblastic responses, as well as the presence of pathological fractures in the ribs. The skeleton's sex and age at death are in agreement with the proposed diagnostic, constituting the first case of malignant carcinoma detected in non‐identified Portuguese human skeletal remains. Copyright © 2009 John Wiley & Sons, Ltd.     

A possible case of treponemal disease from England dating to the 11th–12th century AD

This short report describes a human skeleton from an archaeological site in England showing signs of treponemal disease. A radiocarbon determination indicates that it is firmly pre‐Columbian in date. The implications for recent debates concerning the origin of treponemal disease in Europe are discussed. Copyright © 2010 John Wiley & Sons, Ltd.     

A possible case of hyperparathyroidism in a burial of 15–17th century AD date from Wharram Percy,England

The subject of this paper is the partial skeleton of an adult female, dating to ad 1420–1640, excavated from the church at the deserted village of Wharram Percy, North Yorkshire, UK. Lesions are described which are probably indicative of hyperparathyroidism. Copyright © 2001 John Wiley & Sons, Ltd.     

A cargo of lead ingots from a shipwreck off Ashkelon,Israel 11th–13th centuries AD

Shipwreck cargo of lead ingots, some marked, discovered off Tel Ashkelon, weighed about four tonnes. C14 analysis of charred wood from an ingot dated it to the 11th–13th centuries AD, Crusader times. Lead isotopic ratios provenanced the ingots to Mont‐Lozère, France. Various aspects of the lead trade are discussed, including: lead sources, extraction, casting, lead in the international maritime trade, weight units in medieval trade, prices, transportation, sale and storage, lead cargo and ballast, reconstruction of the wrecking event, salvage after the vessel was wrecked, Ashkelon as a trading coastal town in the 11th–13th centuries AD, and the possible destination of the cargo.     

Lepromatous leprosy in an early mediaeval cemetery in Central Italy (Morrione, Campochiaro, Molise, 6th–8th century AD)

The aim of this study is to investigate and discuss the cases of leprosy diagnosed on two skeletal individuals from an early mediaeval necropolis at Morrione (Campochiaro, Molise, Central Italy), dated to the 6th–8th century AD. At present only two inhumation areas have been found in Campochiaro: one at Morrione and the other at Vicenne. Since no signs of a stable settlement or built-up area have been found, it seems the cemeteries can be attributed to a semi-nomadic Lombard-Avar group. This site may have represented a military outpost to control the area against Byzantine invasions. The skeletons of a female (40–46 years) and a male (50–55 years), from tombs 68 and 108, revealed several bony changes indicative of leprosy with clear rhino-maxillary syndrome in both specimens. There is a scarcity of information in the osteoarchaeological literature of leprosy in ancient Italy. The significance of these cases is that they add to an understanding of the history of the disease in Italy and to the data set necessary to understand the epidemiological dynamics in the Mediterranean basin during the ancient period.     

C4‐Plant Foraging in Northern Italy: Stable Isotopes,Sr/Ca and Ba/Ca Data of Human Osteological Samples from Roccapelago (16th–18th Centuries AD)

Human osteological samples (n = 23) taken from different anatomical parts of 11 individuals from the early modern (16th–18th century AD) site of Roccapelago (Modena, Italy) were systematically analysed for δ¹³C, δ¹⁵N and trace elements to investigate their diet. δ¹³C and δ¹⁵N correlate and show a high variability between individuals, attesting to the dietary contribution of C₄ plants. This is supported by pollen analysis of the burial site samples, which revealed the presence of maize. δ¹⁵N correlates with Sr/Ca, suggesting that the main protein source could have been milk and dairy. We therefore interpret the strong correlation between δ¹³C and δ¹⁵N as evidence for C₄‐plant foraging practice and the exploitation of livestock for meat and milk, combined with possible direct intake of C₄ plants. The Roccapelago site represents an important case study to track the evolution of the post‐medieval diet and the introduction of maize cultivation in southern Europe, as also attested by historical sources.     

Probable early presence of leprosy in Europe in a Celtic skeleton of the 4th–3rd century BC (Casalecchio di Reno,Bologna, Italy)

Examination of the skeleton of an adult male from the Celtic necropolis of Casalecchio di Reno (Bologna, Italy; 4th–3rd century BC) revealed some lesions on the feet, especially bilateral acro‐osteolysis of the metatarsals, and on the tibia, fibula and hand. The morphological and radiographic characteristics of the bones are consistent with a diagnosis of leprosy. Other features of the rhinomaxillary region support this diagnosis. As far as we know, this case could represent the oldest skeletal evidence of leprosy in Europe, indicating the early spread of this disease toward the Western world. Copyright © 2005 John Wiley & Sons, Ltd.     

Ancestry Estimation Based on Morphoscopic Traits in a Sample of African Slaves from Lagos,Portugal (15th–17th Centuries)

In 2009, a skeletal collection of 158 individuals was excavated in Valle da Gafaria, Lagos, Portugal. These individuals were buried in an unusual way, having been discarded in an urban dump located outside the medieval city walls, dated from the 15th–17th centuries. Lagos was, at the time, an important slave trade harbour, and during the excavation, the morphological appearance of the skulls and the presence of intentionally modified teeth in some individuals raised suspicion that they were African slaves. Despite the extensive historical information about the Atlantic slave trade, so far, skeletal remains identified as slaves were scarce, especially in Europe. The aim of the present study is to estimate the ancestry of a sample of 33 adult individuals (28 women and 5 men) recovered in the Valle da Gafaria applying eleven morphological characteristics using the naïve Bayes classifier. When comparing the individuals with four groups of classification (European, African, American Indian and Asian), 24 (72.7%) specimens were classified as Africans with a posterior probability greater than 0.90. When only two groups were considered (the African and the European), 31 (93.9%) individuals were classified as Africans with a posterior probability greater than 0.90. These results are in accordance with the historical record and previous genetic studies, suggesting that this sample represents a rare archaeological sample of great interest to the history of the Atlantic slave trade, that is, the Lagos individuals were probably of African ancestry. Although the ancestry is a parameter of the biological profile mainly estimated in forensic Anthropology, this study confirms the importance of its investigation in past populations. Copyright © 2016 John Wiley & Sons, Ltd.     

Severe vertebral collapse in a juvenile from the graveyard (13th/14th–19th centuries) of the São Miguel church (Castelo Branco,Portugal): differential palaeopathological diagnosis

Diseases that culminate into vertebral collapse are of intricate diagnosis both in palaeopathology and modern clinical practice. When analysing human skeletal remains from the archaeological record this difficulty is amplified due to the absence of complementary medical diagnostic information. This is especially evident when the distinction between tuberculous and pyogenic spondylitis is intended. Taking into consideration this challenging task and based on the macroscopic and radiological study of the skeleton number 8, a specimen exhumed from the East necropolis (13th/14th to 19th centuries) of the São Miguel church, at the Portuguese city of Castelo Branco, the aims of the work here presented are to discuss the range of possible aetiological factors, especially infectious ones, ascribable to the striking pathological changes noticed on this 12‐year‐old individual. These included alterations on the axial skeleton, namely extensive vertebral destruction, presenting as a gibbus deformity, and correlated thoracic deformities. Consubstantiated on palaeopathological and clinical research, tuberculous spondylitis seems to be the most probable cause for the reported lesions. However, the scrutiny between this condition and other pyogenic spinal infections is of extreme complexity when analysing ancient human remains and deserves in‐depth future investigations. Within the framework of the Portuguese archaeological record, the specimen here presented is of major relevance since the pattern and severity of the spinal osseous changes observed were not previously reported. Further, if tuberculous spondylitis is assumed as the most probable diagnosis, the case here presented represents one of the earliest skeletal evidence of this condition in Portugal. Copyright © 2009 John Wiley & Sons, Ltd.     

Skeletal pathology of a high‐ranking official from Thrace (Turkey,last quarter of the 4th century BC)

A male human skeleton from Thrace dated at around 320 BC was found in a wealthy tomb 12 km from what is now Tekirdağ, Turkey. The occupant of the tomb died at the age of 40–45 years and has a pathologic left humerus caused most probably by traumatic injury. It is 9 cm shorter than the right humerus. A drainage fistula penetrating into the medullary cavity occurs at its proximal end. Due to severe arthritic destruction, the left humeral head has completely lost normal articulation, with the glenoid cavity of the left scapula displaying, in turn, severe erosive lesions and important reduction in its articular surface. A marked abscess is discernible bilaterally on the chondro‐costal sternal end. The individual also has a hip with a total sacroiliac joint fusion and shows slight or moderately developed exostoses on different parts of his skeleton. These joint destructions most likely indicate that he suffered from chronic osteomyelitis and septic arthritis. Copyright © 2005 John Wiley & Sons, Ltd.     

Differential diagnosis of cartilaginous dysplasia and probable Osgood–Schlatter's disease in a Mississippian individual from East Tennessee

This paper details the differential diagnosis of an adult female skeleton displaying features consistent with a cartilaginous dysplasia and Osgood–Schlatter's disease. This burial was excavated in 1940 from a Mississippian platform mound at the DeArmond site (40RE12) in Roane County, Tennessee as part of the Works Progress Administration (WPA) and Tennessee Valley Authority (TVA) archaeological investigations. The right humerus and left femur of this individual display traits consistent with achondroplasia, such as shortened length and normal width. However, the rest of the long bones display typical morphology. The affected humerus and femur are 82 mm and 58 mm shorter than their counterparts, respectively. This makes for obvious asymmetry. A review of the various cartilaginous dysplasias was undertaken to identify those conditions concordant with the differential manifestation of the long bone asymmetry. Morphological and radiographic analyses were used to rule out possible diagnoses. The most likely candidate is enchondromatosis out of the presented conditions, as it most commonly affects the long bones, does not affect every bone in the skeleton, and is asymmetrical in its manifestation. In addition to the cartilaginous dysplasia, both anterior proximal tibial metaphyses of this individual display defects that are roughly triangular with pitted, irregular floors. Osgood–Schlatter's disease is caused by repeated trauma to the tibial tuberosity during childhood. This individual would have walked with an obvious limp, and perhaps the added biomechanical stress on both quadriceps muscles as a result caused the injuries and resultant defects to its attachment points. Evidence of these conditions in an adult indicates that the Mississippian people in this community offered some sort of social support to differently‐abled individuals. Copyright © 2009 John Wiley & Sons, Ltd.     

Mandibular Fracture and Dislocation in a Case Study from the Jewish Cemetery of Lucena (CÓRDOBA), in South Iberian Peninsula (8th–12th ad)

The skeletal remains of an adult female have been exhumed in an 11th century tomb in the mediaeval Jewish cemetery of Ronda Sur, in the city of Lucena (Córdoba, Spain). Examination of the skull and mandible revealed evidences of bilateral condylar fracture and dislocation. Lesions were observed macroscopically and radiology was used as a complementary method of scrutiny, especially in cases of unclear observation. Irregular morphology of the condyles and coronoid processes, shallow glenoid fossa, altered and abnormal joint surfaces anterior to the glenoid fossa, and reduced height of both ascending rami were observed. Ante‐mortem tooth loss, slight wear of occlusal surface and asymmetrical occlusal deposit of dental calculus were found. Radiologically, degenerative changes in the condyles and reparative bone in both coronoid processes have been identified. Dislocation of the condyles and lack of adequate treatment probably led to disruption of masticatory patterns and related structures, such as muscle attachments, articular disc and ligaments. Bilateral remodelled fracture and the altered appearance of the joint structures could probably mean that the individual survived the injury by several years. This type of fracture could be the consequence of direct blow to the mental or submental region that was transmitted in a direction that raised the mandible, causing the condylar head to collide directly with the mandibular fossa. Very few mandibular fractures in ancient skulls have been described in Spain, and this case is the first example found in a Spanish archaeological skeletal assemblage. Copyright © 2011 John Wiley & Sons, Ltd.     

Leprosy in a skeleton from the 7th century necropolis of Vicenne‐Campochiaro (Molise,Italy)

Analysis of the skeleton from tomb 144 of the early medieval necropolis of Vicenne‐Campochiaro in Central Italy revealed several features indicative of leprosy. The skeleton belongs to a male estimated to be between 20 and 25 years of age at death. The distal halves of the 1st and 2nd left metatarsals present acro‐osteolysis and both legs show severe subperiosteal bone reaction. The facial skeleton shows changes compatible with a chronic inflammatory process, possibly due to an infectious disease. The anatomical distribution of the lesions and their association with other skeletal lesions seems to be compatible with a near‐lepromatous form of leprosy. A differential diagnosis is made, and the skeletal traits pathognomonic of leprosy are discussed. Copyright © 2005 John Wiley & Sons, Ltd.     

Mining Archaeology and Micro‐Raman Analysis Associated with ESEM‐EDX: Toward a Chrono‐Spatial Definition of Ore Consumption in a Pyrenean Medieval Workshop, 14th–16th Centuries

The rapid expansion of non‐ferrous metallurgy in the late Middle Ages (14th–15th centuries) enhanced ore demand, which was supported by mining intensification. Metallurgical workshops developed various supply strategies based on geological, political and economic constraints. This is particularly true for the Pyrenean multi‐metals workshop of Castel‐Minier (Ariège, France), where recent excavations unearthed an exceptional corpus of non‐ferrous ores. A specific analytical methodology combining micro‐Raman spectroscopy and environmental scanning electron microscopy with energy dispersive X‐ray (ESEM‐EDX) was set up to study these artefacts. This composite methodology permitted the fast characterization of both mineral and gangue as well as a discussion of their economic potential. Ores identified were compared with ancient mines in neighbouring mining districts in order to sketch a geography of the mineral resources available to medieval metallurgists. Moreover, a chrono‐stratigraphic study of ore distribution in Castel‐Minier revealed the supply strategies, technological choices as well as spatializing of copper and lead metallurgies.