On the antiquity of bone tumours: a rare case of osteoblastoma from Medieval Tuscany

Introduction: Osteoblastomas of the skull are rarely documented owing to their different preferential skeletal localization, resulting in few examples in the clinical literature. In paleopathology, general detection of paranasal lesions occurred randomly, mostly in presence of bone breakages or at X-ray or CT examination for other research purposes. Objectives: Any anomaly in the anatomy of the sinuses should be taken into consideration avoiding to minimize the occurrence of bone defects of the paranasal sinuses. Material and Methods: During the archaeological excavations carried out in 2004 in the large Medieval cemetery of Pava Plebs (Siena, central Italy), a skull with evidences of a paranasal lesion was brought to light. The specimen, which belongs to a young-adult male, showed postmortem damage in the frontal bone through which an oval new bone formation has been macroscopically detected. Results: CBCT study confirmed the presence of a bone mass arising from the right frontal sinus, measuring 12,1x4,4 mm, with peripheral radiopaque margins and a small central radiolucent area. Radiological and histological ground section of the lesion suggested a diagnosis of benign neoplasia concerning an osteoblastoma. Conclusion: The Italian case represents a direct and rare evidence of paranasal sinus tumor dated back to the Middle Ages, even resulting the first paleopathological case of osteoblastoma.