Cystic Mandibular Lesion in the Antiquity. A Rare Finding

Ameloblastoma is a not uncommon tumour reported in the clinical literature and is characterised by a multilocular cavity with ‘soap bubble’ pattern usually in the posterior body of the mandible. A review of the palaeopathology literature did not reveal any examples of ameloblastoma. In this paper, a probable case of ameloblastoma in a male skeleton, 45 – 55 years at age of death, from Casserres, Barcelona, Spain, (ca ad V‐IX centuries) is presented. This case was identified during the anthropological study of the remains in the laboratory of biological anthropology in the Universitat Autònoma de Barcelona. The mandible of this individual (AEC'07‐C2‐139) exhibits unusual features, like cavitated lesions in the posterior side of the right gonion and the expansion of the right ramus of the mandible. All these features are consistent with ameloblastoma. Copyright © 2011 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.     

Signs of meningiomas in a skull of the Mexican colonial period

The skull of a native Mexican from the colonial period is studied. The skull has a nasal trauma, dental pathology and two osteogenic lesions, one situated at the left wing of the sphenoid bone and the other in the infrainion occipital squamous bone, between the left mastoid process and the left occipital condyle. That involving the sphenoid occludes the optic nerve foramen and is evident through the orbit and at pterion. These osteogenic lesions are considered to be secondary to the soft tissue tumour mass, which, at the level of its implantation area, is usually present in meningiomas.     

A multiple myeloma of the late middle ages from unterregenbach,southwestern Germany

In the early 1960s the grave of a probable donor was discovered in the St Veit church in Unterregenbach, Stadt Langenburg, Kreis Crailsheim, southwestern Germany. After a re-examination, the skeleton may be regarded as clearly corresponding to the typical clinical picture of a multiple myeloma/plasma cell myeloma. The 45–55-year-old female individual shows all the characteristics of a malignant plasma cell tumour, with specific osteolytic lesions of the skull, vertebrae, ribs, pelvis, scapulae and long bones, and even-sized single defects without reactive zones on the edges. Several pathological fractures of the ribs and a vertebral compression fracture can be observed. The gnawing-mark-like features on the inner surface of the compact bone and the ‘punched-out’ lesions on the outer are distinguishing marks of a multiple myeloma.     

Metastatic carcinoma: palaeopathology and differential diagnosis

A 62 year‐old contemporary white female diagnosed with metastatic carcinoma of the breast was examined after skeletonisation. She never received chemical, hormonal or radiation therapy. Because of the confirmed clinical diagnosis, lack of medicinal intervention, and quality of bone preservation, this specimen provides a comparative standard for metastatic carcinoma and differential diagnosis of idiopathic dry bone pathology. We detail gross and radiographic bone response to this disease and differentially diagnose the skeleton against Langerhans cell histiocytosis and multiple myeloma, conditions capable of modifying bone in characteristic patterns that may mimic metastatic carcinoma. Copyright © 2006 John Wiley & Sons, Ltd.     

Differential diagnosis of a calcified object from a 4th–5th century AD burial in Aqaba,Jordan

In 1997 a calcified object was recovered from the pelvic region of an adult male excavated from an ancient cemetery in Aqaba, Jordan. The cemetery (n = 48) dates to the middle 4th to early 5th century AD and is associated with the Byzantine‐period marine trading centre of Aila located on the Gulf of Aqaba in the Red Sea. The oblong calcification consisted of linearly aligned tubules within a thin shell. Twenty‐eight conditions potentially resulting in calcification within the pelvic region were considered. Of these, five were retained as possible diagnoses due to the object's location and size and the presence of a thin shell and fully calcified tubules. In the end, the object appears to be a calcified, but unidentified, parasite. Copyright © 2008 John Wiley & Sons, Ltd.     

Benign mandibular tumours: Two case studies from the Maya lowland site of Tikal,Guatemala

This study presents a differential diagnosis of benign mandibular tumours identified in two adult burials from the precontact Maya city of Tikal, Guatemala. Both individuals were recovered from domestic structures that date to the Late Classic Period (AD 550–850). The osseous growths were interpreted as probable benign tumours based on evidence of localised growth, a circumscribed border, a dense texture and a lack of osteolytic activity or spiculate bone formation. Burial PTP‐026A is a middle adult (35–50 years) of indeterminate sex with evidence of a small dense, circular mass extending laterally from the right mandibular corpus. Macroscopic and radiographic assessment of this lesion provided a diagnosis of osteoma, a true neoplasm, or alternately, hyperplasia (e.g. exostosis) or hamartoma, which are not true neoplasms. Burial PTP‐017 is a probable young adult female (20–35 years) with a large osteoblastic lesion on the right anterior mandibular corpus. This dense, bony mass extends from the anterior margin of the mental canal, and shows a distinct boundary from the adjacent trabecular and cortical bone. The growth of the osseous mass displaced the right first premolar anteriorly. Radiographic assessment showed the presence of dense, radiopaque material, indicating significant calcification. This suggested a likely fibro‐osseous origin for this lesion, with a probable diagnosis of ossifying fibroma, or possibly osseous dysplasia. Although not definitive, our differential diagnosis was able to exclude a number of neoplastic and non‐neoplastic conditions that affect the jaws. This study provides the first reported cases of possible benign mandibular tumours in the ancient Maya. Copyright © 2009 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.     

Multiple myeloma in an early medieval skeleton

Detailed studies on neoplasms in prehistoric populations are rare. Each well-documented case can therefore add to our knowledge. In former times, palaeopathology could present only tentative diagnoses in the case of tumours. Today, modern diagnostic methods and a comparison with established cases make exact evaluations and their verification possible. During our study it became obvious that criteria for the diagnosis of recent tumours can be used as a guide. In this paper we present the most important findings of a malignant primary bone tumour (multiple myeloma) in an early medieval skeleton and its differential diagnoses. Even in the absence of histological findings, the remaining criteria (X-ray, age, localization, macroscopic features) permit the diagnosis of multiple myeloma to be made with some certainty.