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Original article

Vol. 143 No. 3132 (2013)

Multiple osteosclerotic lesions in an Iron Age skull from Switzerland (320‒250 BC) – an unusual case

  • Negahnaz Moghaddam
  • Rupert Langer
  • Steffen Ross
  • Ebbe Nielsen
  • Sandra Lösch
DOI
https://doi.org/10.4414/smw.2013.13819
Cite this as:
Swiss Med Wkly. 2013;143:w13819
Published
28.07.2013

Summary

The single Hochdorf burial was found in 1887 during construction work in the Canton of Lucerne, Switzerland. It dates from between 320 and 250 BC. The calvarium, the left half of the pelvis and the left femur were preserved. The finding shows an unusual bony alteration of the skull. The aim of this study was to obtain a differential diagnosis and to examine the skull using various methods. Sex and age were determined anthropologically. Radiological examinations were performed with plain X-ray imaging and a multislice computed tomography (CT) scanner. For histological analysis, samples of the lesion were taken. The pathological processing included staining after fixation, decalcification, and paraffin embedding. Hard-cut sections were also prepared. The individual was female. The age at death was between 30 and 50 years. There is an intensely calcified bone proliferation at the right side of the os frontalis. Plain X-ray and CT imaging showed a large sclerotic lesion in the area of the right temple with a partly bulging appearance. The inner boundary of the lesion shows multi-edged irregularities. There is a diffuse thickening of the right side. In the left skull vault, there is a mix of sclerotic areas and areas which appear to be normal with a clear differentiation between tabula interna, diploë and tabula externa. Histology showed mature organised bone tissue. Radiological and histological findings favour a benign condition. Differential diagnoses comprise osteomas which may occur, for example, in the setting of hereditary adenomatous polyposis coli related to Gardner syndrome.

References

  1. Brandstetter JL. 1887. Der Grabfund zu Hochdorf. Der Geschichtsfreund XLII. 261–265 + Tafel II.
  2. Tanner A. without date of print. Die Latènegräber der nordalpinen Schweiz, Heft 4/9. Kantone Luzern und Solothurn: Zürich.
  3. Craig E, Craig G. 2011. The Diagnosis and Context of a Facial Deformity from an Anglo-Saxon Cemetery at Spofforth, North Yorkshire. International Journal of Osteoarchaeology. DOI: 10.1002/oa.1288
  4. Bullough PG. 2010. Orthopaedic Pathology. 5thedition. Mosby Elsevier: Missouri.
  5. Pinhasi R, Mays S. 2008. Advances In Human Palaeopathology. John Wiley & Sons Ltd: West Sussex.
  6. Zink A, Panzer S, Fesq-Martin M, Burger-Heinrich E, Wahl J, Nerlich AG. Evidence for a 7000-Year-Old Case of Primary Hyperparathyroidism. American Medical Association 2005;293:40–2.
  7. Ortner DJ. 2003. Identification of Pathological Conditions in Human Skeletal Remains. Academic Press: London.
  8. Noterman J, Massager N, Vloeberghs M, Brotchi J. Monstrous Skull Ostemeomas in a Probable Gardner’s Syndrome: Case Report. Surgical Neurology 1998;49:302–5.
  9. Liakos GM, Walker CB, Carruth JAS. Ocular complications in craniofacial fibrous dysplasia. Br J Ophthalmol 1979;63:611–6.
  10. Brothwell D, Sandison AT. 1967. Diseases in Antiquity; A Survey of the Diseases Injuries and Surgery of Early Populations. Charles C. Thomas, Springfield: Illinois.
  11. Jaffé H, Lichtenstein L. Solitary unicameral bone cyst: with emphasis on the roentgen picture, the pathologic appearance, and the pathogenesis. Arch Surg. 1942;44:1004–25.
  12. Albright F, Butler AM, Hampton AO, Smith P. Syndrome characterized by osteitis fibrosa disseminata, areas of pigmentation and endocrine dysfunction, with precocious puberty in females: report of 5 cases. N Engl J Med. 1937;216:727–46.
  13. Prates C, Sousa S, Oliveira C, Ikram S. Prostate metastatic bone cancer in an Egyptian Ptolemaic mummy, a proposed radiological diagnosis. International Journal of Paleopathology. 2011;1:98–103.
  14. Lösch S, Moghaddam N, Ross S, Müller F, Langer R. 2012. A Case Of A Malign Tumour In Iron Age Switzerland. The 19th european meeting of the paleopathology association.
  15. Rüttimann D, Lösch S. Mortality and morbidity in the city of Bern, Switzerland, 1805-1815 with special emphasis on infant, child and maternal deaths. HOMO - Journal of Comparative Human Biology. 2012;63:55–66.
  16. Papageorgopoulou C, Suter SK, Rühli FJ, Siegmund F. Harris Lines Revisited: Prevalence, Comorbidities, and Possible Etiologies. American Journal of Human Biology 2011;23:381–91.
  17. Hofmann MI, Papageorgopoulou C, Böni T, Rühli FJ. Two case examples of pelvic fractures in medieval populations from central Europe. J Anthropol Sci. 2010;88:179–88.
  18. Papageorgopoulou C, Rühli FJ, Siegmund F, Woitek U. Assessing dental health predictors in a Swiss medieval population by a spatial probit model. Am J Phys Anthropol. 2010;50:184–184.
  19. Haak W, Gruber P, Rühli FJ, Böni T, Ulrich-Bochsler S, Frauendorf E, et al. Molecular evidence of HLA-B27 in a historical case of ankylosing spondylitis. ARTHRITIS AND RHEUMATISM 2005;52:3318–9.
  20. Rühli FJ, Hotz G, Böni T. Brief communication: The Galler Collection: A little-known historic Swiss bone pathology reference series. Am J Phys Anthropol. 2003;121:15–8.
  21. Ulrich-Bochsler S, Schäublin E, Zeltner THB, Glowatzki G. Invalidisierende Wirbelsäulenverkrümmung an einem Skelettfund aus dem Frühmittelalter (7./8. Bis Anfang 9. Jh.). Ein Fall einer wahrscheinlichen Spondylitis tuberculosa. Schweiz Med Wochenschr. 1982;112:1318–23.
  22. Andreetta A, Lösch S. 2012. Lesions of skeletal tuberculosis on young woman’s knee, buried in S. Giovanni Battista curch in Leontica (Ticino, Switzerland). The 19th european meeting of the paleopathology association.
  23. Müller F, Kaenel G, Lüscher G. 1999. Die Schweiz vom Paläolithikum bis zum frühen Mittelalter. SPM IV. Eisenzeit: Basel.
  24. Ferembach D, Schwidetzky I, Stloukal M. Empfehlungen für die Alters- und Geschlechtsdiagnose am Skelett. Homo – Journal of comparative human biology 1979;30:1–32.
  25. Rösing FW, Graw M, Marre B, Ritz-Timme S, Rothschikd MA, Rötzscher K, et al. Recommendations for the forensic diagnosis of sex and age from skeletons. Homo – Journal of comparative human biology. 2007;58:75–89.
  26. Sjøvold T. 1988. Geschlechtsdiagnose am Skelett. In: Knußmann R (ed) Anthropologie. Handbuch der vergleichenden Biologie des Menschen, vol 1. Gustav Fischer Verlag: Stuttgart; 444.
  27. Hermann B, Grupe G, Hummel S, Piepenbrink H, Schutkowski H. 1990. Prähistorische Anthropologie. Leitfaden der Feld- und Labormethoden. Springer-Verlag: Berlin, Heidelberg, New York.
  28. Szilvássy J. 1988. Altersdiagnose am Skelett. In: Knußmann R (ed.) Anthropologie. Handbuch der vergleichenden Biologie des Menschen, Band I: Allgemeine Anthropologie, vol 1. Gustav Fischer Verlag: Stuttgart; 421–435.
  29. Vallois HV. La durée de la vie chez l’homme fossile. L’Anthropologie. 1937;47:499–532.
  30. Acsádi G, Nemeskéri I. 1970. History of human lifespan and mortality. Academiai Kiado: Budapest.
  31. Hug E. 1956. Die Anthropologische Sammlung im Naturhistorischen Museum Bern. Sonderabdruck aus den Mitteilungen der Naturforschenden Gesellschaft in Bern. Neue Folge 13. Band.
  32. Schoch W, Ulrich-Bochsler S (1987): Die anthropologische Sammlung des Naturhistorischen Museums Bern. Katalog der Neueingänge 1956 bis 1985, in: Jahrbuch des Naturhistorischen Museums Bern 9, Jahrgang 1987, 267–350.
  33. Aufderheide A, Rodriguez-Martin C. 2008. The Cambridge encyclopedia of human palaeopathology. 4th Edition. Cambridge University Press: Cambridge
  34. Bilezikian JP, Silverberg SJ. Asymptomatic Primary Hyperparathryroidism. N Engl J Med. 2004;350:1746–51.
  35. Kerckhaert A, Wolvius E, Van Der Waal K, Oosterhuis W. A giant Osteoma of the mandible: Case report. J Craniomaxillofac Surg. 2005;33:282–5.
  36. Bilkay U, Erdem O, Ozek C, Helvaci E, Kilic K, Ertan Y, Gurler T. Benign Osteomas With Gardner Syndrome: Review of the Literature and Report of a Case. J Craniofac Surg. 2004;15:506–9.
  37. Davies R, Armstrong JG, Thakker N, Horner K, Guy SP, Clancy T, et al. Severe Gardner Syndrome in Families with Mutations Restricted to a Specific Region of the APC Gene. Am J Hum Genet. 1995;57:1151–8.
  38. Gardner EJ, Plenk HP. Hereditary Pattern for Multiple Osteomas in a Family Group. Am J Hum Genet. 1952;4:31–6.
  39. Gardner EJ. A Genetic and Clinical Study of Intestinal Polyposis, a Predisposing Factor for Carcinoma of the Colon and Rectum. The American Journal of Human Genetics 1951;3:167–76.
  40. Gu GL, Wang SL, Wei XM, Bai L. Diagnosis and treatment of Gardner syndrome with gastric polyposis: A case report and review of the literature. World Journal of Gastroenterology 2008;14:2121–3.
  41. Fotiadis C, Tsekouras DK, Antonakis P, Sfiniadakis J, Genetzakis M, Zografos GC. Gardner’s syndrome: A case report and review of the literature. World Journal of Gastroenterology 2005;11:5408–11.
  42. Remmele W. 1996. Pathologie 2, Verdauungstrakt. Springer Verlag: Heidelberg; 642–643.
  43. Burger J and Bollongino R. Guidelines for the recovery, acquisition and storage of skeletal samples for palaeogenetical analyses. Bulletin der Schweizerischen Gesellschaft für Anthropologie 2010;16:71–8.
  44. Burger J, Tresset A and Vigne JD. Environment and excavation: pre-lab impacts on ancient DNA analyses. Comptes Rendus Palevol. 2008;7:91–8.
  45. Rehemtulla A. Dinosaurs and Ancient Civilizations: Reflections on the Treatment of Cancer. Neoplasia 2010;12:957–68.

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