Secondary cancer in an Anglo-Saxon female

A mature/elderly female skeleton from the Anglo-Saxon cemetery at Eccles, Kent, is described. A diagnosis of Paget's disease of the left tibia is made. The macroscopic radiological features of perforating and non-perforating osteolytic lesions in the cranium and femora are described. The differential diagnosis is discussed. The lesions are considered to be due to metastatic carcinoma, possibly from a primary carcinoma of the breast. There is a brief resumé of other recorded examples of metastatic carcinoma in early skeletons.     

Neolithic case of metastasizing carcinoma: Multiple approaches to differential diagnosis

The remains of the fragmented skeleton of a mature male individual from a Neolithic mass burial (ca. 5000 years BP) are presented. The lesions consist of osteoblastic proliferation and replacement of previously normal haematopoietic tissue. The most affected area seems to have been the iliac blade. So-called ‘seeding’ of tumour tissue has been found in different loci in the femoral neck, sacrum, L4 and scapula. Differential diagnosis points to metastatic carcinoma, most likely from the prostrate gland. In order to support the observations, radiological and histological analyses have been performed. Trace element analyses of tumour and control samples have shown the limited contribution of these data to ascertain the aetiology of secondary neoplasias in buried material.     

A probable case of metastatic carcinoma from the late prehistoric eastern Tennessee River Valley

There are few described cases of metastatic carcinoma from the prehistoric eastern United States and none primarily differentially diagnosed from the southeast. A mature adult female exhibiting several large lytic cranial lesions suggestive of neoplastic disease was identified in a late prehistoric Mississippian Period (AD 1200–1600) context. Burial 371 is from Ledford Island, a Mouse Creek phase (AD 1400–1500) site from the Chickamauga Reservoir of southeastern Tennessee. It is the only case in this reservoir (total adult n = 843). The radiographs of the otherwise asymptomatic postcranium yielded radiolucencies in both proximal femora, both medial clavicles, the sternum, the surviving humeral metaphysis and fragmentary innominate. The locations are all consistent with metastasized carcinoma. The identity of the possible primary lesion is argumentative. Age, sex and the mixed nature of the osseous response are consistent with carcinoma of the breast but not to the exclusion of bronchogenic, thyroid, or kidney cancers. Copyright © 2002 John Wiley & Sons, Ltd.     

Better a Broader Diagnosis Than a Misdiagnosis: The Study of a Neoplastic Condition in a Male Individual who Died in Early 20th Century (Coimbra,Portugal)

The paleopathological record of neoplastic conditions in the past is considered scarce. The detection of tumours in ancient populations is hindered by the quality and quantity of signs visible on the skeleton, the methodological approach, the preservation of remains, and by difficulties of differential diagnosis. The aims of this paper are to report the extensive and multiple osteolytic lesions observed in an adult male and to discuss the possible etiology of these lesions. The individual, a 71‐year‐old male who died in 1932, is part of the Coimbra Identified Skeletal Collection. Records indicate that he died of a ‘heart lesion’. The present study used macroscopic, radiological, and computerized tomography examinations to analyse the skeletal remains of the individual number 439. The type and pattern of the lesions detected, which were most prominent on the skull, were compared with both clinical and paleopathological diagnostic criteria for different nosologic groups. The differential diagnosis addresses problems expressed both in clinical and in paleopathological literature with regard to the difficulties in distinguishing metastatic tumours from multiple myeloma. The nature of the lesions represented by this individual precludes an exact diagnosis. Therefore, we employed a broader category, neoplastic condition, instead of choosing a more specific diagnosis that would likely have resulted in a misdiagnosis due to overlapping features on this individual's condition. Further investigations are necessary to establish more replicable indicators and to improve confidence in retrospective diagnosis of these types of conditions. Copyright © 2011 John Wiley & Sons, Ltd.     

A nineteenth-century case of carcinoma of the prostate,with a note on the early history of the disease

A case of prostatic carcinoma is described in the skeleton of a named individual who died in 1834. The tumour was recognized from widespread periosteal new bone throughout the skeleton and by the presence of sclerosing metastases in many bones, including the pelvis and all the vertebrae. A number of features of the disease present here are said to be uncommon in modern patients, including spiculated periosteal new bone and some degree of spinal stenosis. In two previous cases of prostatic carcinoma described in the literature, periosteal new bone was a prominent feature and was probably responsible for the disease being recognized. It is likely that if skeletons from mature males were routinely X-rayed, considerably more cases would be noted and a more accurate estimate of the prevalence of this disease in the past would thus be ascertained. © 1997 John Wiley & Sons, Ltd.     

Metastatic Cancer in the Middle Age: The Possible Case of a Female Skeleton from Bormio (Italy)

Secondary signs of cancer are difficult to assess in the archaeological context, as other lesions may mimic metastases on dry bones. Furthermore, the low life expectancy, lower level of environmental cancer risk factors and pollution than the present times can contribute in limiting the frequency of signs of cancer in archaeological populations. This study focuses on a female adult skeleton from the necropolis of Bormio (North Italy), dating back to Middle Ages, which shows multiple lytic lesions on cranium, upper limbs, ribs and pelvis; lesions are oval in shape, with a diameter ranging from 1–2 to 80 mm. The lesions appearance and distribution at macroscopic and radiographic level, together with sex and age indications, suggest the diagnosis of metastatic cancer. Possible diagnostic hypotheses of the possible sites of original cancer were performed as well, based on modern epidemiological data. Copyright © 2017 John Wiley & Sons, Ltd.     

A possible case of metastatic carcinoma in a middle Sican burial from Batán Grande,Perú

The skeleton of a young to middle-aged adult excavated at the base of the Pre-Incaic pyramid of Huaca Las Ventanas, northern coast of Peru, shows an osteoplastic formation on the fifth lumbar vertebra compatible with a diagnosis of metastatic carcinoma, possibly from the prostate gland.     

A case of metastatic carcinoma from 18th century London

In 1999 the AOC Archaeology Group excavated the cemetery of All Hallows by the Tower, London, UK, prior to redevelopment. The majority of the burials are post‐medieval, dating from circa 1776 to 1835. Skeleton (4105) was buried with a lead coffin plate. The data on the coffin plate revealed that the skeleton was that of Ann Sumpter, who died aged 31 years on the 25 May 1794. The skeleton displays pathology that is indicative of a metastatic carcinoma. A precise diagnosis is not possible, but given the individual is female it is statistically most likely the secondaries have originated from a breast or lung tumour. Breast tumours are thought to have been more common than lung tumours in the past, and therefore the most probable diagnosis is a breast carcinoma. Copyright © 2006 John Wiley & Sons, Ltd.     

Nasopharyngeal carcinoma: a review of its causes and its diagnosis in skeletal material

Smoky fires in small, poorly ventilated structures have been cited as a risk factor for nasopharyngeal carcinoma (NPC) since the 1920s (Dobson, 1924 ). Furthermore, based on five cited cases of ancient NPC, it has been proposed that NPC was a common condition with a wide geographical distribution in ancient populations (Wells, 1964a , b ). Both interpretations have continued to appear in the literature (Ortner, 2003 ), but recently, Aufderheide & Rodríguez‐Martín ( 1998 ) have argued that the number of cases of NPC is inflated due to ‘diagnostic imprecision’. This paper reviews medical advances that in the last few decades have shed considerable light on risk factors for NPC, and also reviews criteria for diagnosing NPC. Based on these data, a reexamination of the five cited cases of ancient NPC suggests that only one case may be NPC, and the prevalence and distribution of this disease may have been more variable than originally thought. Furthermore, a better understanding of the aetiology of NPC and criteria for diagnosis may allow for more precise research designs for studying ancient populations. Copyright © 2007 John Wiley & Sons, Ltd.