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Lai S, Tomer N. Hyperostosis fronto-parietalis - radiology mimic of metastasis: A case report. Radiol Case Rep 2021; 16:2244-2247. [PMID: 34194589 PMCID: PMC8239443 DOI: 10.1016/j.radcr.2021.05.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 11/06/2022] Open
Abstract
Hyperostosis frontalis interna (HFI) is a benign entity manifested by bony overgrowth in the frontal endocranial surface. It is most commonly reported incidentally among postmenopausal elderly women. Tracer uptake appearances of HFI can vary on planar bone scans, enabling it to be easily confounded with bone metastases. We report a case of HFI in a 69-year-old postmenopausal female with treated left breast cancer detected on bone scintigraphy, with subsequent confirmation by computed tomography. Our case highlights the importance of having awareness of HFI and its key pattern findings to avoid mistaking it for pathology, and to recognise the use of computed tomography and hybrid fusion imaging techniques as reliable diagnostic tools for HFI.
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Affiliation(s)
- Szeyi Lai
- Department of Radiology, Darlington Memorial Hospital, Hollyhurst Rd, Darlington, DL3 6HX, UK
| | - Neeru Tomer
- Department of Radiology, Darlington Memorial Hospital, Hollyhurst Rd, Darlington, DL3 6HX, UK
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Laffranchi Z, Milella M, Lombardo P, Langer R, Lösch S. Co-occurrence of malignant neoplasm and Hyperostosis Frontalis Interna in an Iron Age individual from Münsingen-Rain (Switzerland): A multi-diagnostic study. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2021; 32:1-8. [PMID: 33176226 DOI: 10.1016/j.ijpp.2020.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/28/2020] [Accepted: 10/28/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To re-analyze one of the oldest cases of malignant bone neoplasm with different analytical techniques. MATERIAL The available skeletal remains of grave 138 (G138) from the Iron Age necropolis of Münsingen-Rain (Switzerland, 420-240 BC). METHODS The bones are analyzed by means of morphological, radiographic, histological, and biogeochemical methods. RESULTS The individual, a male aged between 35-50 years old, presents morphologically and radiographically a previously described coral-like bone neoformation on the proximal left humerus. The new analyses highlight previously undocumented coarse bone proliferation on the left scapula and lobular apposition on the endocranial surface of the frontal bone. The histological analysis of the humerus shows a 'lace-like' pattern of osteoid deposition without lamellation. CONCLUSIONS Our data support a diagnosis of osteoblastic malignant neoplasm, probably an osteosarcoma or, more likely, a dedifferentiated chondrosarcoma for the humerus and scapula, and of hyperostosis frontalis interna on the frontal. The co-presence of a malignant neoplasm and hyperostosis frontalis interna may be related to a hormonal imbalance, a possibility also suggested by atypical funerary treatment. SIGNIFICANCE This study confirms G138 as one of the oldest cases of malignant bone neoplasm, adds new paleopathological data on this individual, and demonstrates the advantages of a multidisciplinary approach. LIMITATIONS The discussion of the pathological changes is limited by the representation and preservation of the skeletal elements. SUGGESTION FOR FUTURE RESEARCH Biomolecular and protein biomarkers analyses may help to refine the diagnostic conclusions.
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Affiliation(s)
- Zita Laffranchi
- Department of Physical Anthropology, Institute of Forensic Medicine, University of Bern. Sulgenauweg 40, CH-3007, Bern Switzerland.
| | - Marco Milella
- Department of Physical Anthropology, Institute of Forensic Medicine, University of Bern. Sulgenauweg 40, CH-3007, Bern Switzerland.
| | - Paolo Lombardo
- Inselspital, Universitätsspital Bern, Universitätsinstitut für Diagnostische, Interventionelle und Pädiatrische Radiologie (DIPR). Freiburgstrasse 10, CH-3010, Bern Switzerland.
| | - Rupert Langer
- Institute of Pathology, University of Bern. Murtenstrasse 31, CH-3008, Bern Switzerland.
| | - Sandra Lösch
- Department of Physical Anthropology, Institute of Forensic Medicine, University of Bern. Sulgenauweg 40, CH-3007, Bern Switzerland.
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Cvetković D, Jadžić J, Milovanović P, Djonić D, Djurić M, Ivović M, Nikolić S, Živković V. Comparative Analysis of Femoral Macro- and Micromorphology in Males and Females With and Without Hyperostosis Frontalis Interna: A Cross-Sectional Cadaveric Study. Calcif Tissue Int 2020; 107:464-473. [PMID: 32748007 DOI: 10.1007/s00223-020-00740-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/25/2020] [Indexed: 01/03/2023]
Abstract
We hypothesized that subjects with hyperostosis frontalis interna (HFI), which represents local, endocranial thickening of the frontal bone, would express extra-calvarial manifestations of this condition. Therefore, we compared femoral bone mineral density, geometry, and microarchitecture of males and females with HFI to those without this condition as well as between males and females with HFI. The sample was taken from human donor cadavers, 38 males (19 with and 19 without HFI) and 34 females (17 with and 17 without HFI) that were age-matched within the same sex. The specimens of femoral bones were scanned using microcomputed tomography and dual-energy X-ray absorptiometry (DXA). Parameters of hip structure analysis (HSA) were calculated from data derived from DXA scans. Females with HFI had increased cortical bone volume fraction and their cortical bone was less porous compared to females without HFI. Males with HFI showed microarchitectural differences only with the trabecular bone. They had increased bone volume fraction and decreased trabecular separation compared to males without HFI, although with borderline significance. These microarchitectural changes did not have significant impact on femoral geometry and bone mineral density. The same, still unknown etiological factor behind HFI might be inducing changes at the level of bone microarchitecture at a remote skeletal site (femoral bone), in both sexes. These alterations still do not have the magnitude to induce obvious, straightforward overall increase of bone mineral density measured by DXA. HFI could be a systemic phenomenon that affects both males and females in a similar manner.
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Affiliation(s)
- Danica Cvetković
- Institute of Forensic Medicine, University of Belgrade - School of Medicine, 31a Deligradska Str., 11000, Belgrade, Serbia
| | - Jelena Jadžić
- Laboratory for Anthropology and Skeletal Biology, Institute for Anatomy, University of Belgrade - School of Medicine, Dr. Subotica 4/2, 11000, Belgrade, Serbia
| | - Petar Milovanović
- Laboratory for Anthropology and Skeletal Biology, Institute for Anatomy, University of Belgrade - School of Medicine, Dr. Subotica 4/2, 11000, Belgrade, Serbia
| | - Danijela Djonić
- Laboratory for Anthropology and Skeletal Biology, Institute for Anatomy, University of Belgrade - School of Medicine, Dr. Subotica 4/2, 11000, Belgrade, Serbia
| | - Marija Djurić
- Laboratory for Anthropology and Skeletal Biology, Institute for Anatomy, University of Belgrade - School of Medicine, Dr. Subotica 4/2, 11000, Belgrade, Serbia
| | - Miomira Ivović
- Clinic for Endocrinology, Clinical Center of Serbia, Dr. Subotica 13, 11000, Belgrade, Serbia
| | - Slobodan Nikolić
- Institute of Forensic Medicine, University of Belgrade - School of Medicine, 31a Deligradska Str., 11000, Belgrade, Serbia
| | - Vladimir Živković
- Institute of Forensic Medicine, University of Belgrade - School of Medicine, 31a Deligradska Str., 11000, Belgrade, Serbia.
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Cvetković D, Jadžić J, Milovanović P, Djonić D, Djurić M, Bracanović D, Nikolić S, Živković V. Micro-computed Tomography Study of Frontal Bones in Males and Females with Hyperostosis Frontalis Interna. Calcif Tissue Int 2020; 107:345-352. [PMID: 32712779 DOI: 10.1007/s00223-020-00730-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/14/2020] [Indexed: 01/12/2023]
Abstract
Hyperostosis frontalis interna (HFI) represents irregular thickening of the endocranial surface of the frontal bone, mostly seen in postmenopausal females. The microarchitecture of this condition is poorly studied. The aim of this cross-sectional autopsy study was to investigate and compare microarchitectural structure of the frontal bone affected with HFI in both sexes and to test whether HFI severity could be distinguished at the microarchitectural level. The sample was taken from human donor cadavers, 19 males (61 ± 15 years old) and 17 females (75 ± 15 years old). After classification of HFI severity (type A, B, C or D), samples of the frontal bone were taken and scanned using micro-computed tomography. Bone volume fraction was higher and total porosity lower only in the outer table of males with HFI, compared to females with HFI. Mean total sample thickness differed only between males with HFI type A and D. Bone microarchitecture between males and females with corresponding HFI types (e.g., male with type A versus female with type A) differed only in HFI type C regarding the fractal dimension of diploe. The degree of anisotropy differed between HFI subtypes in males, but the post hoc analysis revealed no significant differences between individual groups. Other microarchitectural parameters did not differ among males with different HFI subtypes, as well in females, in any part of the frontal bone. There is no difference in microarchitectural structure of the frontal bone between males and females with HFI, in general aspect and within corresponding HFI subtypes. HFI severity could not be distinguished at the microarchitectural level, neither in males nor in females.
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Affiliation(s)
- Danica Cvetković
- Institute of Forensic Medicine, University of Belgrade - School of Medicine, 31a Deligradska Str., Belgrade, 11000, Serbia
| | - Jelena Jadžić
- Laboratory for Anthropology and Skeletal Biology, Institute for Anatomy, University of Belgrade - School of Medicine, Dr. Subotica 4/2, Belgrade, 11000, Serbia
| | - Petar Milovanović
- Laboratory for Anthropology and Skeletal Biology, Institute for Anatomy, University of Belgrade - School of Medicine, Dr. Subotica 4/2, Belgrade, 11000, Serbia
| | - Danijela Djonić
- Laboratory for Anthropology and Skeletal Biology, Institute for Anatomy, University of Belgrade - School of Medicine, Dr. Subotica 4/2, Belgrade, 11000, Serbia
| | - Marija Djurić
- Laboratory for Anthropology and Skeletal Biology, Institute for Anatomy, University of Belgrade - School of Medicine, Dr. Subotica 4/2, Belgrade, 11000, Serbia
| | - Djurdja Bracanović
- Laboratory for Anthropology and Skeletal Biology, Institute for Anatomy, University of Belgrade - School of Medicine, Dr. Subotica 4/2, Belgrade, 11000, Serbia
- Department of Radiology, University of Belgrade - School of Dentistry, 4 Rankeova Str., Belgrade, 11000, Serbia
| | - Slobodan Nikolić
- Institute of Forensic Medicine, University of Belgrade - School of Medicine, 31a Deligradska Str., Belgrade, 11000, Serbia
| | - Vladimir Živković
- Institute of Forensic Medicine, University of Belgrade - School of Medicine, 31a Deligradska Str., Belgrade, 11000, Serbia.
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Szeniczey T, Marcsik A, Ács Z, Balassa T, Bernert Z, Bakó K, Czuppon T, Endrődi A, Évinger S, Farkas Z, Hlavenková L, Hoppál K, Kálmán Kiss C, Kiss K, Kocsis K, Kovács LO, Kovács PF, Köhler K, Költő L, Kővári I, László O, Lovász G, Lovranits J, Lukács J, Masek Z, Merczi M, Molnár E, Németh CE, Ódor JG, Paja L, Pap I, Patay R, Rácz I, Rácz Z, Ritoók Á, Szenthe G, Szilas G, Szőke BM, Tóth Z, Vida T, Wolff K, Finnegan M, Hajdu T. Hyperostosis frontalis interna in ancient populations from the Carpathian Basin - A possible relationship between lifestyle and risk of development. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2019; 24:108-118. [PMID: 30342349 DOI: 10.1016/j.ijpp.2018.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 10/02/2018] [Accepted: 10/03/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The prevalence of hyperostosis frontalis interna (HFI) was examined in different periods of the Carpathian Basin from 4900 BCE to 17th century AD. The study seeks to evaluate temporal changes in HFI and the possible impact of lifestyle on it. MATERIALS The studied material consisted of 4668 crania from Hungary and Serbia. METHODS The crania were analyzed employing macroscopic and endoscopic examination. RESULTS In historic periods, sex and age played a pivotal role in HFI development. Among predominantly pastoralist populations of the 5th-8th and 10th centuries, prevalence of HFI was considerably higher than in the medieval populations of the 9th-17th centuries. CONCLUSIONS In addition to age and sex, other factors could be implicated in HFI development. The physiological effects of the pastoralist lifestyle and diet on insulin regulation could explain the increased risk of developing HFI in the 5th-8th and 10th-century populations. SIGNIFICANCE The study provides the first comprehensive dataset of HFI from different archaeological periods from the Carpathian Basin. It has implications for lifestyle and risk of HFI development in past populations. LIMITATIONS The archaeological periods are not equally represented. SUGGESTIONS FOR FURTHER RESEARCH In order to better understand the etiology of HFI, lifestyle factors can be used to elucidate the risk of developing HFI in ancient populations.
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Affiliation(s)
- Tamás Szeniczey
- Department of Biological Anthropology, Institute of Biology, Faculty of Science, Eötvös Loránd University, Budapest, H-1117, Hungary.
| | - Antónia Marcsik
- Department of Biological Anthropology, University of Szeged, Szeged, H-6720, Hungary
| | - Zsófia Ács
- Department of Archaeological Excavations and Artefact Processing, Hungarian National Museum, Budapest, H-1088, Hungary
| | | | - Zsolt Bernert
- Department of Anthropology, Hungarian Natural History Museum, Budapest, H-1083, Hungary
| | - Katalin Bakó
- Budavári Ingatlanfejlesztő és Üzemeltető Nonprofit Ltd., Budapest, H-1013, Hungary
| | | | - Anna Endrődi
- Department of Prehistoric and Migration Period, Budapest History Museum, Aquincum Museum and Archaeological Park, H-1014, H-1031, Budapest, Hungary
| | - Sándor Évinger
- Department of Anthropology, Hungarian Natural History Museum, Budapest, H-1083, Hungary
| | | | - Lucia Hlavenková
- Institute for History of Medicine and Foreign Languages, Charles University, Prague, 121 08, Czech Republic
| | - Krisztina Hoppál
- Silk Road Research Group, Hungarian Academy of Sciences-Eötvös Loránd University-Szeged University, Budapest, Hungary
| | | | - Krisztián Kiss
- Department of Biological Anthropology, Institute of Biology, Faculty of Science, Eötvös Loránd University, Budapest, H-1117, Hungary
| | - Kinga Kocsis
- Roska Tamás Doctoral School of Sciences and Technology, Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, H-1083, Hungary; Neuronal Network and Behavior Research Group, Institute of Cognitive Neuroscience and Psychology, Research Center for Natural Sciences, Hungarian Academy of Sciences, Budapest, H-1117, Hungary
| | - Loránd Olivér Kovács
- Department of Archaeological Excavations and Artefact Processing, Hungarian National Museum, Budapest, H-1088, Hungary
| | | | - Kitti Köhler
- Institute of Archaeology, Research Centre for the Humanities, Hungarian Academy of Sciences, Budapest, H-1097, Hungary
| | | | - Ivett Kővári
- International Committee of the Red Cross, Geneva, 1202, Switzerland
| | - Orsolya László
- Archaeological Heritage Directorate, Hungarian National Museum, Budapest, H-1113, Hungary
| | | | - Júlia Lovranits
- Department of Biological Anthropology, University of Szeged, Szeged, H-6720, Hungary
| | - József Lukács
- Budavári Ingatlanfejlesztő és Üzemeltető Nonprofit Ltd., Budapest, H-1013, Hungary
| | - Zsófia Masek
- Institute of Archaeology, Research Centre for the Humanities, Hungarian Academy of Sciences, Budapest, H-1097, Hungary
| | | | - Erika Molnár
- Department of Biological Anthropology, University of Szeged, Szeged, H-6720, Hungary
| | - Csilla Emese Németh
- Department of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, H-1094, Hungary
| | | | - László Paja
- Department of Biological Anthropology, University of Szeged, Szeged, H-6720, Hungary
| | - Ildikó Pap
- Department of Anthropology, Hungarian Natural History Museum, Budapest, H-1083, Hungary
| | - Róbert Patay
- Ferenczy Museum Center, Szentendre, H-2000, Hungary
| | - István Rácz
- Department of Biological Anthropology, Institute of Biology, Faculty of Science, Eötvös Loránd University, Budapest, H-1117, Hungary; Department of Archaeometry and Archaeological Methodology, Institute of Archaeological Sciences, Eötvös Loránd University, Budapest, H-1088, Hungary
| | - Zsófia Rácz
- Department of Early Medieval and Historical Archaeology, Institute of Archaeological Sciences, Eötvös Loránd University, Budapest, H-1088, Hungary
| | - Ágnes Ritoók
- Department of Archaeology, Hungarian National Museum, Budapest, H-1088, Hungary
| | - Gergely Szenthe
- Department of Archaeology, Hungarian National Museum, Budapest, H-1088, Hungary
| | - Gábor Szilas
- Department of Prehistoric and Migration Period, Budapest History Museum, Aquincum Museum and Archaeological Park, H-1014, H-1031, Budapest, Hungary
| | - Béla Miklós Szőke
- Institute of Archaeology, Research Centre for the Humanities, Hungarian Academy of Sciences, Budapest, H-1097, Hungary
| | - Zoltán Tóth
- Dobó István Castle Museum, Eger, H-3300, Hungary
| | - Tivadar Vida
- Department of Early Medieval and Historical Archaeology, Institute of Archaeological Sciences, Eötvös Loránd University, Budapest, H-1088, Hungary
| | - Katalin Wolff
- Department of Early Medieval and Historical Archaeology, Institute of Archaeological Sciences, Eötvös Loránd University, Budapest, H-1088, Hungary
| | - Michael Finnegan
- Department of Sociology, Anthropology and Social Work, Kansas State University, Manhattan, KS, 66506, USA
| | - Tamás Hajdu
- Department of Biological Anthropology, Institute of Biology, Faculty of Science, Eötvös Loránd University, Budapest, H-1117, Hungary.
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Hyperostosis frontalis interna as an age-related phenomenon - Differences between males and females and possible use in identification. Sci Justice 2018; 59:172-176. [PMID: 30798865 DOI: 10.1016/j.scijus.2018.09.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 09/16/2018] [Accepted: 09/23/2018] [Indexed: 11/21/2022]
Abstract
Hyperostosis frontalis interna (HFI) is a condition manifested by thickening of the inner surface of the frontal bone and it could be useful when dealing with the identification of human remains in various anthropological and forensic investigations. We compared the macroscopic appearance and morphologic (metric) features of the skulls in cases with and without HFI, in both sexes, and wanted to establish whether age determined occurrence of HFI. To achieve this aim, we performed prospective autopsy study, covering ten-year period (2007-2016). Study group consisted of southeast Europe Caucasian subjects, with determined age and sex. The severity of HFI was classified by two forensic pathologists independently, according to the four types (A-D) proposed by Hershkovitz et al. Thicknesses of the frontal and temporal bones, as well as the longitudinal and frontal diameters of the skulls were measured. The sample consisted of 35 males and 112 females with HFI, and 55 males and 202 females without HFI (404 individuals in total). Type B was the most common type of HFI among males (45%) and type C among females (41%). HFI type D was almost four times more common in females than in males (OR = 3.73). Frontal and temporal bones were thicker in all subjects who have HFI. Thickness of the skull was not age-dependent, in the entire sample, or in subjects with HFI, or in the control group (in all the cases Spearman's Rho was <0.3). Age seemed to be a predicting factor for HFI occurrence only in females. Females younger than 55 years have similar risk for HFI occurrence as males. An unidentified skull with the general markers of old age and severe form HFI is most probably from a female decedent.
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Western AG, Bekvalac JJ. Hyperostosis frontalis interna in female historic skeletal populations: Age, sex hormones and the impact of industrialization. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2016; 162:501-515. [PMID: 27901271 DOI: 10.1002/ajpa.23133] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 11/02/2016] [Accepted: 11/05/2016] [Indexed: 11/05/2022]
Abstract
OBJECTIVES This analysis aims to investigate the impact of industrialization on the prevalence of Hyperostosis Frontalis Interna (HFI), focusing on the roles of age and parity to examine the claim that longevity and changing reproductive patterns have led to increased rates in modern populations. MATERIALS AND METHODS A total of 138 individuals from two documented London skeletal assemblages of the Industrial period were analyzed employing macroscopic observation, digital radiography and MicroCT scanning to establish the prevalence rates of HFI according to modern clinical standards. Statistical analysis was also undertaken on a sub-sample of 51 females of post-menopausal age to identify any relationship between parity and HFI. RESULTS The majority of cases of HFI were found in older females, reflecting clinical observations. The prevalence rates of HFI corresponded well to those predicted from the proportion of old age females present within populations. Age was therefore shown to be a predominant factor in HFI presence. A plateau in HFI prevalence was noted from the age of 50-59 years onwards. No statistically significant relationship was found between parity and HFI. DISCUSSION When recorded consistently, HFI was positively correlated with age and longevity but had also increased among old age females over time. Our results suggest that nulliparity co-occurs with HFI but is not a primary factor in its pathogenesis. Key factors in HFI presence in females are likely to be increased androgens and the dysregulation of insulin and insulin-like growth factor-1.
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Affiliation(s)
- A G Western
- Centre for Human Bioarchaeology, Museum of London, London, England
| | - J J Bekvalac
- Centre for Human Bioarchaeology, Museum of London, London, England
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Ponti G, Manfredini M, Ruini C. Wall paintings facies and their possible genetic correlates in the ancient Pompeii: A bio-anthropologic message from the past? Gene 2016; 589:151-6. [PMID: 27107679 DOI: 10.1016/j.gene.2016.04.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 04/16/2016] [Accepted: 04/18/2016] [Indexed: 11/30/2022]
Abstract
The figurative arts and precisely the ancient Pompeian wall paintings portraits can provide an additional source of information in supplementing bio-anthropological studies. There are several genetic diseases with a wide spectrum of congenital bone stigmata in association to distinctive facial features. Gorlin-Goltz syndrome, also named nevoid basal cell carcinoma syndrome, is an autosomal dominant syndrome characterized by unusual skeletal changes, such as macrocephaly, facial asymmetry, hypertelorism, frontal and parietal bossing caused by germline mutations of the gene PTCH1. The Gorlin syndrome, clinically defined in 1963, existed during Dynastic Egyptian times, as revealed by a spectrum of skeletal findings compatible with the syndrome in mummies dating back to three thousand years ago and, most likely, in the ancient population of Pompeii. In the present research, we discuss the potential relationship between Pompeian wall paintings portrait and the cranio-metric bone changes revealed among the Pompeian skull collections assuming that the ancient portraits can constitute an important tool that should be strictly integrated with osteologic and biomolecular data in order to argue a syndromic diagnosis in ancient population.
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Affiliation(s)
- Giovanni Ponti
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest transplant, Oncological and Regenerative Medicine, Clinical Pathology Unit, University of Modena and Reggio Emilia, Modena, Italy.
| | - Marco Manfredini
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest transplant, Oncological and Regenerative Medicine, Dermatology Unit, University of Modena and Reggio Emilia, Modena 41124, Italy
| | - Cristel Ruini
- Department of Dermatology, Staedtisches Klinikum Muenchen, Munich, Germany; Department of Dermatology and Allergology, Ludwig Maximilian University, Munich, Germany
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Balzeau A, Charlier P. What do cranial bones of LB1 tell us about Homo floresiensis? J Hum Evol 2016; 93:12-24. [PMID: 27086053 DOI: 10.1016/j.jhevol.2015.12.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 11/04/2015] [Accepted: 12/09/2015] [Indexed: 12/01/2022]
Abstract
Cranial vault thickness (CVT) of Liang Bua 1, the specimen that is proposed to be the holotype of Homo floresiensis, has not yet been described in detail and compared with samples of fossil hominins, anatomically modern humans or microcephalic skulls. In addition, a complete description from a forensic and pathological point of view has not yet been carried out. It is important to evaluate scientifically if features related to CVT bring new information concerning the possible pathological status of LB1, and if it helps to recognize affinities with any hominin species and particularly if the specimen could belong to the species Homo sapiens. Medical examination of the skull based on a micro-CT examination clearly brings to light the presence of a sincipital T (a non-metrical variant of normal anatomy), a scar from an old frontal trauma without any evident functional consequence, and a severe bilateral hyperostosis frontalis interna that may have modified the anterior morphology of the endocranium of LB1. We also show that LB1 displays characteristics, related to the distribution of bone thickness and arrangements of cranial structures, that are plesiomorphic traits for hominins, at least for Homo erectus s.l. relative to Homo neanderthalensis and H. sapiens. All the microcephalic skulls analyzed here share the derived condition of anatomically modern H. sapiens. Cranial vault thickness does not help to clarify the definition of the species H. floresiensis but it also does not support an attribution of LB1 to H. sapiens. We conclude that there is no support for the attribution of LB1 to H. sapiens as there is no evidence of systemic pathology and because it does not have any of the apomorphic traits of our species.
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Affiliation(s)
- Antoine Balzeau
- Équipe de Paléontologie Humaine, UMR 7194 du CNRS, Département de Préhistoire, Muséum National d'Histoire Naturelle, Paris, France; Department of African Zoology, Royal Museum for Central Africa, B-3080 Tervuren, Belgium.
| | - Philippe Charlier
- Section of Medical and Forensic Anthropology, UFR of Health Sciences (UVSQ/Paris-Descartes University, AP-HP), Montigny-Le-Bretonneux, France
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Royle NA, Booth T, Valdés Hernández MC, Penke L, Murray C, Gow AJ, Maniega SM, Starr J, Bastin ME, Deary IJ, Wardlaw JM. Estimated maximal and current brain volume predict cognitive ability in old age. Neurobiol Aging 2013; 34:2726-33. [PMID: 23850342 PMCID: PMC3988920 DOI: 10.1016/j.neurobiolaging.2013.05.015] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2012] [Revised: 05/07/2013] [Accepted: 05/16/2013] [Indexed: 11/16/2022]
Abstract
Brain tissue deterioration is a significant contributor to lower cognitive ability in later life; however, few studies have appropriate data to establish how much influence prior brain volume and prior cognitive performance have on this association. We investigated the associations between structural brain imaging biomarkers, including an estimate of maximal brain volume, and detailed measures of cognitive ability at age 73 years in a large (N = 620), generally healthy, community-dwelling population. Cognitive ability data were available from age 11 years. We found positive associations (r) between general cognitive ability and estimated brain volume in youth (male, 0.28; females, 0.12), and in measured brain volume in later life (males, 0.27; females, 0.26). Our findings show that cognitive ability in youth is a strong predictor of estimated prior and measured current brain volume in old age but that these effects were the same for both white and gray matter. As 1 of the largest studies of associations between brain volume and cognitive ability with normal aging, this work contributes to the wider understanding of how some early-life factors influence cognitive aging.
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Affiliation(s)
- Natalie A Royle
- Brain Research Imaging Centre, Neuroimaging Sciences, University of Edinburgh, Edinburgh, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Edinburgh, UK; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
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Royle N, Hernández MV, Maniega SM, Arabisala B, Bastin M, Deary I, Wardlaw J. Influence of thickening of the inner skull table on intracranial volume measurement in older people. Magn Reson Imaging 2013; 31:918-22. [PMID: 23453763 PMCID: PMC3682185 DOI: 10.1016/j.mri.2013.01.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 01/15/2013] [Accepted: 01/17/2013] [Indexed: 11/19/2022]
Abstract
Introduction It is generally assumed that intracranial volume (ICV) remains constant after peaking in early adulthood. Thus ICV is used as a ‘proxy’ for original brain size when trying to estimate brain atrophy in older people in neuroimaging studies. However, physiological changes in the skull, such as thickening of the frontal inner table, are relatively common in older age and will reduce ICV. The potential influence that inner table skull thickening may have on ICV measurement in old age has yet to be investigated. Methods We selected 60 (31 males, 29 females) representative older adults aged 71.1–74.3 years from a community-dwelling ageing cohort, the Lothian Birth Cohort 1936. A semi-automatically derived current ICV measurement obtained from high resolution T1-weighted volume scans was compared to the estimated original ICV by excluding inner skull table thickening using expert manual image processing. Results Inner table skull thickening reduced ICV from an estimated original 1480.0 ml to a current 1409.1 ml, a median decrease of 7.3% (Z = − 6.334; p < 0.001), and this reduction was more prominent in women than men (median decrease 114.6 vs. 101.9 ml respectively). This led to potential significant underestimations of brain atrophy in this sample by 5.3% (p < 0.001) and obscured potential gender differences. Conclusions The effects of skull thickening are important to consider when conducting research in ageing, as they can obscure gender differences and result in underestimation of brain atrophy. Research into reliable methods of determining the estimated original ICV is required for research into brain ageing.
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Affiliation(s)
- N.A. Royle
- Brain Research Imaging Centre, Neuroimaging Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Department of Clinical Neurosciences, The University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - M.C. Valdés Hernández
- Brain Research Imaging Centre, Neuroimaging Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Department of Clinical Neurosciences, The University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - S. Muñoz Maniega
- Brain Research Imaging Centre, Neuroimaging Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Department of Clinical Neurosciences, The University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - B.S. Arabisala
- Brain Research Imaging Centre, Neuroimaging Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Department of Clinical Neurosciences, The University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - M.E. Bastin
- Brain Research Imaging Centre, Neuroimaging Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Department of Clinical Neurosciences, The University of Edinburgh, Edinburgh, EH4 2XU, UK
| | - I.J. Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - J.M. Wardlaw
- Brain Research Imaging Centre, Neuroimaging Sciences, University of Edinburgh, Edinburgh, EH4 2XU, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Scottish Imaging Network, A Platform for Scientific Excellence (SINAPSE) Collaboration, Department of Clinical Neurosciences, The University of Edinburgh, Edinburgh, EH4 2XU, UK
- Corresponding author. Brain Research Imaging Centre (BRIC), Neuroimaging Sciences, Western General Hospital, Edinburgh, EH4 2XU, UK. Tel.: + 44 131 537 2943.
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May H, Mali Y, Dar G, Abbas J, Hershkovitz I, Peled N. Intracranial volume, cranial thickness, and hyperostosis frontalis interna in the elderly. Am J Hum Biol 2012; 24:812-9. [DOI: 10.1002/ajhb.22325] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Revised: 08/09/2012] [Accepted: 08/26/2012] [Indexed: 11/10/2022] Open
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Belcastro MG, Todero A, Fornaciari G, Mariotti V. Hyperostosis frontalis interna (HFI) and castration: the case of the famous singer Farinelli (1705-1782). J Anat 2011; 219:632-7. [PMID: 21740437 DOI: 10.1111/j.1469-7580.2011.01413.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The famous castrato singer Farinelli (1705-1782) was exhumed by our research group in July 2006 for the purpose of gaining some insight into his biological profile through a study of his skeletal remains. Farinelli was castrated before puberty to preserve the treble pitch of the boy's voice into adult life. His powerful and sweet voice became legendary. In spite of its bad preservation state, the skeleton displayed some interesting characteristics that are probably related to the effects of castration, including long limb-bones, persistence of epiphyseal lines and osteoporosis. In particular, the frontal bone was affected by severe hyperostosis frontalis interna (HFI). This condition consists in a symmetrical thickening of the inner table of the bone. The epidemiology of HFI shows that it is relatively common in postmenopausal women but very rare in men. Men affected by this pathology suffer from diseases, syndromes or treatments causing androgen deficiency. In the case of Farinelli, castration was probably responsible for the onset and development of this lesion.
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Affiliation(s)
- Maria Giovanna Belcastro
- Laboratory of Bioarchaeology and Forensic Osteology, Department of Experimental Evolutionary Biology, Alma Mater Studiorum University of Bologna, Bologna, Italy.
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May H, Peled N, Dar G, Hay O, Abbas J, Masharawi Y, Hershkovitz I. Identifying and classifying hyperostosis frontalis interna via computerized tomography. Anat Rec (Hoboken) 2011; 293:2007-11. [PMID: 21046669 DOI: 10.1002/ar.21274] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The aim of this study was to recognize the radiological characteristics of hyperostosis frontalis interna (HFI) and to establish a valid and reliable method for its identification and classification. A reliability test was carried out on 27 individuals who had undergone a head computerized tomography (CT) scan. Intra-observer reliability was obtained by examining the images three times, by the same researcher, with a 2-week interval between each sample ranking. The inter-observer test was performed by three independent researchers. A validity test was carried out using two methods for identifying and classifying HFI: 46 cadaver skullcaps were ranked twice via computerized tomography scans and then by direct observation. Reliability and validity were calculated using Kappa test (SPSS 15.0). Reliability tests of ranking HFI via CT scans demonstrated good results (K > 0.7). As for validity, a very good consensus was obtained between the CT and direct observation, when moderate and advanced types of HFI were present (K = 0.82). The suggested classification method for HFI, using CT, demonstrated a sensitivity of 84%, specificity of 90.5%, and positive predictive value of 91.3%. In conclusion, volume rendering is a reliable and valid tool for identifying HFI. The suggested three-scale classification is most suitable for radiological diagnosis of the phenomena. Considering the increasing awareness of HFI as an early indicator of a developing malady, this study may assist radiologists in identifying and classifying the phenomena.
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Affiliation(s)
- Hila May
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
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May H, Peled N, Dar G, Abbas J, Hershkovitz I. Hyperostosis frontalis interna: what does it tell us about our health? Am J Hum Biol 2011; 23:392-7. [PMID: 21387460 DOI: 10.1002/ajhb.21156] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2010] [Revised: 12/14/2010] [Accepted: 12/23/2010] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To examine whether the prevalence and severity of hyperostosis frontalis interna (HFI) has significantly changed during the past 100 years. METHODS Two female populations, 100 years apart, were studied; 992 historic and 568 present day females. Detection of HFI was carried out via direct observation or CT images (Brilliance 64, Philips Medical Systems, Cleveland, Ohio). HFI was graded according to Hershkovitz et al.’s (1999) 4-scale definition and according May et al.’s (2010c) 3-scale definition. RESULTS Following correction for age, present day females manifested a significantly higher HFI prevalence compared with historic females (P < 0.05). The risk of developing HFI was found to be approximately 2.5 times greater in present day females compared with females living 100 years ago (P < 0.05). In the young age cohort, present day females manifested a significantly higher prevalence of HFI type B (P < 0.05), whereas in the old age cohort, a significant difference in the prevalence of HFI types C and D was noted between the two groups (P < 0.05). HFI tended to appear at a younger age in the present population. The last two decades has witnessed an increase in HFI prevalence(from 55.6% to 75%). CONCLUSIONS HFI prevalence has increased during the last century, especially among young individuals, possibly indicating a profound change in human fertility patterns, together with the introduction of various hormonal treatments) and new dietary habits.
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Affiliation(s)
- Hila May
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, 69978, Israel
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Hyperostosis frontalis interna – A marker of social status? Evidence from the Bronze-Age “high society” of Qatna, Syria. HOMO-JOURNAL OF COMPARATIVE HUMAN BIOLOGY 2011; 62:30-43. [DOI: 10.1016/j.jchb.2010.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Accepted: 12/07/2010] [Indexed: 11/20/2022]
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