Paleo-oncology at the University of Pisa: recent results.

In recent years, the Division of Paleopathology of the University of Pisa has dedicated a line of research to paleo-oncology. The attention was focused on the analysis of numerous skeletal series, which provided evidence of both benign and malignant tumors. The study of the material from the necropolis of Casal Bertone (Rome), dated back to the first Imperial age (1st-2nd centuries AD), has permitted to diagnose a case of metastatic carcinoma. A male individual aged 50-60 years showed osteolytic and osteoblastic le- sions mainly involving the axial bones, in particular the sternum, ribs, spine, shoulder and pelvic girdle. The anatomical distribution and the nature of the lesions, being both destructive and proliferative, suggested a diagnosis of diffuse metastases from a soft tissue primary cancer. Considering the sex of the individual and the macroscopic and radiological features of the tumor, a prostate cancer is the most likely option. The individual was buried close to a fullonica, therefore it can be hypothesized that he was employed in such activity. It is not possible to ascertain the impact of environmental conditions on the development of the tumor of this individual; we can only leave as an open question whether the use of dyes and alkaline deter- gents such as soda or urine, sulfur, and clay for the treatment of fabrics might have favored the onset of the pathology. Two interesting cases of benign neoplasms come from the cemetery of Pieve di Pava (Siena), dated back to the Medieval period (10th-12th centuries AD). A young male showed a post-mortal breakage of the frontal bone, which highlighted the presence of an oval neo- formation in the right frontal sinus. The Cone Beam Computed Tomography study confirmed the presence of a mass measuring 11x4.8 mm, with peripheral radiopaque margins and a small central radiolucent area. The histological study allowed to diagnose a case of osteoblastoma, a rare benign tumor consisting of various components of osteogenic mesenchyme pro- ducing osteoid and poorly mineralized woven bone trabeculae. This case is the first paleopathological evidence of osteoblastoma of the frontal sinus. Final- ly, a 40-50 years old woman was affected by several rounded-shaped new bone formations, of which nine localized on the external cranial surface and three on the long bones. The Cone Beam Computed Tomog- raphy confirmed that the lesions were composed of compact bone. Macroscopic and radiological features suggested a diagnosis of multiple non-syndromic os- teomata. Single cranial osteomata are commonly ob- served in osteoarchaeological remains, but multiple osteomata are a rare paleopathological condition. Every ancient cases of neoplastic diseases discov- ered among the osteoarchaeological populations shed new light on our knowledge of their presence and evolution over time. Moreover, the study of paleo- oncology is of considerable relevance not only for the awareness of the prevalence of tumors in the past, but also for the understanding of current carcinogenesis trends.