What’s that big thing on your head? Diagnosis of a large frontoparietal lesion on an Eastern Zhou skull from Henan, China

Pechenkina, Kate; Fan, Wenquan; Luo, Xianping

doi:10.1016/j.ijpp.2019.06.003

Cited by 6 publications

(4 citation statements)

References 59 publications

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“…In adults, careful differential diagnosis regarding trauma is important. We particularly single out the case studies of Pechenkina et al [ 62 ] and Kornafel et al [ 63 ] as models for what all of us in paleopathology should be doing.…”

Section: Discussionmentioning

confidence: 99%

“…For example, Danforth and colleagues [ 31 ] consider other diagnoses unlikely rather than excluded. Pechenkina and colleagues [ 62 ] find angioma more likely than meningioma in their case, and angioma as well as unidentified tumor are considered as alternatives in a medieval case from Poland [ 63 , 64 ]. Ortner and Putschar [ 54 ] suggest that the lesion observed in their case study might also be an eosinophilic granuloma, carcinoma, or angioma.…”

Section: Data Collection and Analysismentioning

confidence: 99%

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Meningiomas in Ancient Human Populations

Cook

Danforth

2022

Cancers

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Meningiomas are the most common tumor of the central nervous system and can result in skeletal manifestations, including hyperostosis of the adjacent cranial bone, enostoses, depressions, and enhanced vascular impressions. However, their identification in the paleopathological literature has been rare and few cases have received broad acceptance of the diagnosis. A review of the literature identified some 43 cases in which individuals were argued to have suffered from meningiomas. Most were seen in older individuals but were more likely to affect males. Eleven individuals exhibited hyperostosis, the most easily recognized indicator, usually located on the parietal bone; the hyperostotic region averaged 8 cm in diameter and 3.0 cm in height. Seven displayed lytic lesions with areas much smaller in size than the hyperostosis, and many had vascular changes. The other cases had indicators that varied greatly in terms of location and expression and included both sclerotic lesions and hollow areas. Several authors also suggested other possible causes of the lesions. The findings reflect the non-pathognomonic nature of the effects of meningiomas. However, given their likely frequency and potentially severe effects in ancient people, it is argued that they should be taken into consideration more frequently when performing differential diagnoses.

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Section: Discussionmentioning

confidence: 99%

Section: Data Collection and Analysismentioning

confidence: 99%

Meningiomas in Ancient Human Populations

Cook

Danforth

2022

Cancers

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“…That term is spicules. Huggins [39] suggested that some meningiomas present with spikes parallel with the cranial surface, although neither Kim et al [42] nor Phemister [56] identified any such findings. Arana et al [6] referred to surface alterations as spicules, despite the smooth or multinodular ectocranial appearance, as Daffner et al [24] noted.…”

Section: Controversy As To Macroscopic Appearancementioning

confidence: 98%

Recognizing and Distinguising the Phenomenon Referred to as Meningioma

Rothschild¹

2022

Preprint

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Background: The reliability of a recent review of meningiomas in the archeologic record was difficult to assess, given the inverted sex ratio of the report and other contents apparently at variance with anatomical/medical findings in scientifically-identified cases. It therefore seemed appropriate to reexamine the nature of meningiomas and derive improve criteria for their recognition in the archeologic record and distinguish them from hemangiomas and bone marrow hyperplasia (recognized in the form of porotic hyperostosis). Methods: Medically-documented cases of meningiomas, hemangiomas and cranial bone marrow hyperplasia were examined to establish a macroscopic standard that distinguishing among them. Alleged cases in the archeologic record were examined for conformity with those criteria. Results: An en face pattern of uniform mesh with contained whorls appears pathognomonic for meningiomas. This contrasts with the non-uniform marrow expansion displacement of trabeculae in porotic hyperostosis and non-uniform vascular displacement of trabeculae in hemangiomas. Reassessment of past attributions revealed few cases of meningiomas that could be confidently diagnosed. Those identified has sex ratios parsimonious with medical literature reports. Conclusions: Criteria suggested for identifying meningiomas permits distinguishing from hemangiomas, bone marrow hyperplasia (porotic hyperostosis) and from the macroscopically-observable surface spicules characteristic of osteosarcomas. Examination for fulfillment of criteria for meningiomas and hemangiomas seems to provide a picture (including sex ratios) more parsimonious with the clinical literature, concluding that Cook and Danforth’s disparate ratios were related to less fastidious case selection. Additionally, confidence in recognizing porotic hyperostosis may be compromised because of apparent similar macroscopic alterations to those seen with hemangiomas.

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“…That term is spicules. Huggins [29] suggested that some meningiomas present with spikes parallel to the cranial surface, although neither Pechenkina et al [41], Kim et al [24] nor Phemister [25] identified any such findings. Arana et al [31] referred to surface alterations as spicules, despite the smooth or multinodular ectocranial appearance, as Daffner et al [42] noted.…”

Section: Controversy As To Macroscopic Appearancementioning

confidence: 99%

Recognizing and Distinguishing the Phenomenon Referred to as Meningioma

Rothschild

2022

Anatomia

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Background: The reliability of a recent review of meningiomas in the archeologic record was difficult to assess, given the inverted sex ratio of the report and other contents apparently at variance with anatomical/medical findings in scientifically identified cases. It therefore seemed appropriate to reexamine the nature of meningiomas and derive improve criteria for their recognition in the archeologic record and distinguish them from hemangiomas and bone marrow hyperplasia (recognized in the form of porotic hyperostosis). Methods: Medically documented cases of meningiomas were examined to establish a macroscopic standard distinguishing them. Alleged cases in the archeologic record were examined for conformity with those criteria. Results: An en face pattern of uniform mesh with contained whorls appears pathognomonic for meningiomas. This contrasts with the non-uniform marrow expansion displacement of trabeculae in porotic hyperostosis and non-uniform vascular displacement of trabeculae in hemangiomas. Reassessment of past attributions revealed few cases of meningiomas that could be confidently diagnosed. Those identified have sex ratios parsimonious with medical literature reports. Conclusions: Criteria suggested for identifying meningiomas permit distinguishing from hemangiomas, bone marrow hyperplasia (porotic hyperostosis) and from the macroscopically observable surface spicules characteristic of osteosarcomas. Examination for fulfillment of criteria for meningiomas and hemangiomas seems to provide a picture (including sex ratios) mirroring that of the clinical literature, concluding that Cook and Danforth’s disparate ratios were related to less fastidious case selection. Additionally, confidence in recognizing porotic hyperostosis may be compromised because of apparent similar macroscopic alterations to those seen with hemangiomas.

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What’s that big thing on your head? Diagnosis of a large frontoparietal lesion on an Eastern Zhou skull from Henan, China

Cited by 6 publications

References 59 publications

Meningiomas in Ancient Human Populations

Meningiomas in Ancient Human Populations

Recognizing and Distinguising the Phenomenon Referred to as Meningioma

Recognizing and Distinguishing the Phenomenon Referred to as Meningioma

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