A Case of Mandibular Tumour in a Skull from an Early Modern Cemetery in Wroclaw, Poland

Abstract

Background: The objective of our study was to diagnose a case of non-malignant bone tissue malformation in an adult female, located in the midline of the mandibular body, as a part of skeletal material excavated from the Early Modern cemetery in Wrocław. Methods and Findings:The macroscopically identified tumour-like hyperplastic lesion was examined using radiographic imaging techniques but also analysed for histopathological features. We identified signs of periosteal reaction and irregular growth of bone tissue which macroscopically resembled a spongy structure. The recorded image shows an irregular hyperplasia of bone lamellae, formed on the inner side of the mandibular corpus, causing secondary changes in the normal structure of the compacted bone and partly in spongy bone. Both techniques confirmed that this condition is most characteristic of a neoplastic lesion, defined as osteoma spongiosum. Conclusions:Growing tumour finally caused a massive deformation of the alveolar part of the mandible. The immediate consequence of such overgrowth of bone tissue was probably the intravital loss of incisors and change of occlusion affecting periodontal health. Therefore it could have significantly deteriorated the quality of life of the studied individual. The identified mandibular osteoma spongiosum is the first case of this type reported for the historic area of Wrocław. We believe that information on neoplastic disorders of bone in archaeological skeletal materials, when properly diagnosed and described, may be an important contribution to epidemiological studies on neoplastic diseases among ancient and contemporary human populations.

A palaeoepidemiological investigation of osteomata, with reference to medieval Poland

“…Although the rational of Kaplan et al, (1994) can also be applied to cranial osteomata, Eshed et al (2002) suggested that, based on their histological features, these lesions be reclassified as hamartoma, a malformation that resembles a neoplasm but results from faulty development. In palaeopathological case reports of osteomata, these lesions are referred to as tumours, and the debate regarding their status as a neoplasm is either not mentioned or not discussed (Blau, 2006; Castro et al, 2019; Dąbrowski et al, 2015; Galassi et al, 2020; Giuffra et al, 2019; Licata, Borgo, Armocida, Nicosia, & Ferioli, 2016; Piombino‐Mascali, Zink, & Panzer, 2017; Premužić & Šikanjic, 2013; Odes et al, 2018; Smith, 2010; Zias, 2006). Bartelink and Wright (2011) seem to be the only researchers who did note this debate in their report of a mandibular tumour from Guatemala, dated to the 6 th to 9 th century CE.…”