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Rare Case of an Ancient Craniofacial Osteosarcoma with Probable Surgical Intervention

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Pathology & Oncology Research

Abstract

Osteosarcoma is the most common primary malignant bone tumor both today and in antiquity. Nevertheless, it is a comparatively rare tumor. This paper describes a case of a highly aggressive craniofacial lesion from the 11th–12th centuries AD, most likely representing osteosarcoma. During the paleopathological study, macroscopic, endoscopic, radiological, scanning-electron and light microscopic investigations were performed. The skull of the approximately 40–50 year-old female revealed several pathological findings. The most impressive macroscopic feature was an extensively spiculated periosteal reaction (“sunburst” pattern) in combination with a massive bone destruction most likely derived from a highly aggressive tumor originating in the ethmoidal area of the medial wall of the orbit. The central parts of the lesion showed excessive new and most probably neoplastic bone formation indicating an underlying high-grade osteosarcoma. The light microscopic examination revealed three different levels of bony structures representing different qualities of bone tissues. Besides the mass lesion, signs of a healed multiple incomplete trephination of the left parietal bone was observed. This case represents a unique example in which the concomitance of a tumor and an incomplete trephination could be observed from the skeletal remains of an ancient individual. The case opens new considerations as to whether surgical interventions, such as incomplete trephination, might have been used already in the Middle Ages as a therapeutic approach.

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Acknowledgements

This research was supported by grants from the Hungarian National Scientific Research Foundation (OTKA) project number NN 78696, TÁMOP 4.2.4. A/1-11-1-2012-0001 „National Excellence Program – Elaborating and operating an inland student and researcher personal support system” and ELTE Talent Management Council.

We would like to acknowledge our debt of gratitude to Kendra Sirak for language editing of the manuscript.

The authors thank Michael Brandt for the production of the thin-ground samples and Ingrid Hettwer-Steeger for the preparation of the samples for scanning-electron microscopy, both Department of Anatomy, University Medical School Göttingen, Germany.

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Authors and Affiliations

  1. Department of Biological Anthropology, University of Szeged, Közép fasor 52, Szeged, H-6726, Hungary

    Erika Molnár & Antónia Marcsik

  2. Department of Anatomy, University Medical School Göttingen, Kreuzbergring 36, D-37075, Göttingen, Germany

    Michael Schultz & Tyede H. Schmidt-Schultz

  3. Department of Botany, Hungarian Natural History Museum, Könyves Kálmán körút 40, Budapest, H-1097, Hungary

    Krisztina Buczkó

  4. Health Center, Kaposvár University, Guba Sándor utca 40, Kaposvár, H-7400, Hungary

    Péter Zádori & Gergely Biró

  5. Department of Anthropology, Hungarian Natural History Museum, Ludovika tér 2, Budapest, H-1083, Hungary

    Zsolt Bernert & Tamás Hajdu

  6. Bone Tumor Reference Center at the Institute of Pathology, University Hospital Basel, Schönbeinstrasse 40, D-, 4031, Basel, Switzerland

    Daniel Baumhoer

  7. Department of Biological Anthropology, Institute of Biology, Eötvös Loránd University, Pázmány Péter sétány 1/c, Budapest, H-1117, Hungary

    Tamás Hajdu

Authors
  1. Erika Molnár
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  2. Michael Schultz
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  3. Tyede H. Schmidt-Schultz
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  4. Antónia Marcsik
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  5. Krisztina Buczkó
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  6. Péter Zádori
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  7. Gergely Biró
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  8. Zsolt Bernert
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  9. Daniel Baumhoer
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  10. Tamás Hajdu
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Corresponding author

Correspondence to Erika Molnár.

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Michael Schultz is a shared first author of the manuscript.

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Molnár, E., Schultz, M., Schmidt-Schultz, T.H. et al. Rare Case of an Ancient Craniofacial Osteosarcoma with Probable Surgical Intervention. Pathol. Oncol. Res. 23, 583–587 (2017). https://doi.org/10.1007/s12253-016-0153-7

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  • DOI: https://doi.org/10.1007/s12253-016-0153-7

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