Possible prostate cancer in northern Peru: Differential diagnosis, vascular anatomy, and molecular signaling in the paleopathology of metastatic bone disease

Metastatic cancer along ancient Silk Road: A possible case from Xinjiang (China)

OBJECTIVE

Palaeopathological evidence of cancer, especially metastatic cancer, is rare in China. This paper describes and diagnoses a cranium with multiple lytic lesions recovered from the Sampula cemetery in Xinjiang, attempting to diagnose the type of disease that could have caused the pathological lesions observed.

MATERIAL

A cranium from an adult male (#00106) was recovered from the Sampula cemetery (dated to 55 BCE to 335 CE) located in the Luopu County, the Hotan River oasis on the southern edge of the Tarim Basin in southern Xinjiang.

METHODS

The cranium was assessed macroscopically and radiographically (CT).

RESULTS

Multiple osteolytic lesions with irregular and "moth-eaten" margins were detected in cranium #00106. CT scans revealed the development of the lesions began at the diploe and identified a "button sequestrum".

CONCLUSIONS

Based on lesion characteristics, metastatic carcinoma was likely the cause of lesions found in cranium #00106.

SIGNIFICANCE

This case has expanded our knowledge of the malignant neoplasms of ancient populations in northwest China and discusses the possible risk factors in the occurrence of cancer in the Sampula site, as well as the possible impacts of skeletal metastases on the individual.

LIMITATIONS

The distribution of osteolytic lesions over the complete skeleton cannot be observed because of the unavailability of postcranial bone.

SUGGESTIONS FOR FUTURE RESEARCH

With the increasing number of reports describing diseases in ancient China, the patterns of diseases occurrence and development can be further explored from spatial and temporal perspectives.

Using a multimethod life history approach to navigate the osteological paradox: A case study from Prehispanic Nasca, Peru

OBJECTIVES

We leverage recent bioarchaeological approaches and life history theory to address the implications of the osteological paradox in a study population. The goal of this article is to evaluate morbidity and mortality patterns as well as variability in the risk of disease and death during the Late Intermediate period (LIP; 950-1450 C.E.) in the Nasca highlands of Peru. We demonstrate how the concurrent use of multiple analytical techniques and life history theory can engage the osteological paradox and provide salient insights into the study of stress, frailty, and resilience in past populations.

MATERIALS AND METHODS

Crania from LIP burial contexts in the Nasca highlands were examined for cribra orbitalia (n = 325) and porotic hyperostosis (n = 270). All age groups and both sexes are represented in the sample. Survivor/nonsurvivor analysis assessed demographic differences in lesion frequency and severity. Hazard models were generated to assess differences in survivorship. The relationship between dietary diversity and heterogeneity in morbidity was assessed using stable δ¹⁵ N and δ¹³ C isotope values for bone collagen and carbonate. One hundred and twenty-four crania were directly AMS radiocarbon dated, allowing for a diachronic analysis of morbidity and mortality.

RESULTS

The frequency and expression of both orbital and vault lesions increases significantly during the LIP. Survivor/nonsurvivor analysis indicates cranial lesions co-vary with frailty rather than robusticity or longevity. Hazard models show (1) decreasing survivorship with the transition into the LIP, (2) significantly lower adult life expectancy for females compared to males, and (3) individuals with cranial lesions have lower survivorship across the life course. Stable isotope results show very little dietary diversity. Mortality risk and frequency of pathological skeletal lesions were highest during Phase III (1300-1450 C.E.) of the LIP.

CONCLUSION

Results provide compelling evidence of increasing physiological stress and mortality in the Nasca highlands during the LIP, but also reveal substantial heterogeneity in frailty and the risk of death. Certain members of society experienced a heavier disease burden and higher mortality compared to their contemporaries. Elevated levels of disease and lethal trauma among females account for some of the sex differences in survivorship but cannot explain the large degree of female-biased mortality. We hypothesize that parental investment in males or increased female fertility rates may explain these differences.

An introduction to advances in Andean South American paleopathology

In the 20 years since the publication of John Verano's foundational paper "Advances in Paleopathology of Andean South America," paleopathological and bioarchaeological investigations of human skeletal remains in the region have increased dramatically. Today, primary foci have grown to span the identification of disease, detailed reconstructions of biocultural interactions, embodied social experiences, and ancient living worlds. In this special issue, more than a dozen scholars reflect on the state of developments in the scientific analyses of ancient disease, life, and society across the region. For this introductory article, we frame the current state of Andean paleopathology by reviewing key historical contributions beginning in the last century. More recent trends since 1997 are defined via a meta-analysis of the literature. We then highlight current innovations and consider future directions of study. We then close with an overview of the papers comprising this special issue. Each article explores major theoretical, topical, and methodological advances that have transpired since 1997 and charts the course for the next two decades of work - with implications and insights that transcend the Andes and speak to key paleopathological issues around the world.

An Ancient Skeleton with Multiple Osteoblastic Bone Lesions Containing a Scapular Sunburst Appearance from a 5th-6th Century Grave Excavated in Oita, Japan

A human skeleton of a middle-aged adult male was found in a 5th–6th century Kinoue-Kodo stone coffin excavated from the southwest marginal region of the Oita plains, northeast Kyushu, Japan. The skeleton was buried respectfully in the ancient tomb, and red pigment was applied to his face after death. We report herein findings from computed tomography imaging of the skeleton and discuss the multiple osteoblastic lesions identified in the humerus, scapula, clavicle, vertebra, pelvic bones, and skull of this individual. These lesions comprised cortical bone thickening with periosteal reaction localized to the surface and osteosclerotic changes mainly observed in the trabecular structure of cancellous bone. In particular, a typical sunburst pattern was also noted on the left scapula as another characteristic lesion found in this case. By differential diagnosis, the disease suffered by this individual was most likely to be metastatic bone tumors, especially of prostate cancer. This person may have survived until many bone metastases had developed throughout his whole body.

Paleo-oncology: Taking stock and moving forward

This article serves as an introduction to the International Journal of Paleopathology's special issue, Paleo-oncology: Taking Stock and Moving Forward. Reflecting the goals of the special issue, this paper has been designed to provide an overview of the current state of paleo-oncology, to introduce new and innovative paleo-oncological research and ideas, and to serve as a catalyst for future discussions and progress. This paper begins with an overview of the paleo-oncological evidence that can be found in ancient remains, followed by a summary of significant paleo-oncological findings and methodological advances to date. Thereafter, challenges in estimating past prevalence of cancer are highlighted and recommendations are made for future advancements in paleo-oncological research. The ground-breaking studies included in the special issue and referenced throughout this introduction embody the many ways in which progress can be made in the field of paleo-oncology.