RESUMEN
Forensic anthropology (FA) as a specialized discipline has been practised in multi-lingual Switzerland for over a decade. A variety of expertise regarding osteological assessments as well as facial image comparison (FIC) is provided by different centres. Nevertheless, information is lacking about the awareness of FA and its benefits for forensic investigations among forensic stakeholders. Therefore, a survey was sent to Swiss anthropologists (AN) and related professions (police officers, prosecutors, and forensic pathologists) to assess three main aspects: (1) the experience of working (biological/forensic) anthropologists within FA; (2) how FA is perceived by other professions within the legal system; and (3) identify gaps (if any) in understanding of FA with the aim to suggest avenues for improvement if necessary. The results show that awareness of FA varies by occupation and cantonal regions. In areas where close collaborations between forensic anthropologists (FAs) and other stakeholders have been formally established, be it with focus on osteological analyses or FIC, the awareness of FA competencies was superior to areas where this was not the case. An overwhelming majority of forensic actors expressed interest in continuing education related to the role of FA. These findings indicate that facilitation of communication and collaboration leads to improvement in the awareness of the competencies of FAs and their contribution to forensic investigations.
Asunto(s)
Antropología Forense , Policia , Humanos , Antropología Forense/métodos , Suiza , Cara , Encuestas y CuestionariosRESUMEN
Virtual Anthropology (VA) transposes the traditional methods of physical anthropology to virtual environments using imaging techniques and exploits imaging technologies to devise new methodological protocols. In this research, we investigate whether the measurements used in the Diagnose Sexuelle Probabiliste (DSP) and Ischio-Pubic Index (IPI) differ significantly when 3D models of a bone are generated using 3D surface scans (3DSS) and Multidetector Computed Tomography (MDCT) scans. Thirty pelvises were selected from the SIMON identified skeletal collection. An equal ratio of females to males was sought, as well as a good preservation of the bones. The pelvises were scanned using an MDCT scanner and a 3D surface scanner. The measurements of the DSP and IPI methods on the dry bones (referred to as macroscopic measurements here), and then to the 3D models. The intra- and interobserver, using the Technical Error of Measurement (TEM) and relative Technical Error of Measurement (rTEM) error was assessed, and we aimed to observe if the measurements made on the MDCT and 3DSS generated models were significantly different from those taken on the dry bones. Additionally, the normality of the data was tested (Shapiro-Wilk test) and the differences in measurements was evaluated using parametric (Student t-tests) and non-parametric (Wilcoxon) tests. The TEM and rTEM calculations show high intra and interobserver consistency in general. However, some measurements present insufficient inter- and intraobserver agreement. Student t and Wilcoxon tests indicate potentially significant differences of some measurements between the different environments. The results show that especially in the virtual environment, it is not easy to find the right angle for some of the DSP measurements, However, when comparing the measurement differences between dry and virtual bones, the results show that most of the differences are less than or equal to 2.5 mm. Considering the IPI, the landmarks are already difficult to determine on the dry bone, but they are even more difficult to locate in the virtual environment. Nevertheless, this study shows that quantitative methods may be better suited for application in the virtual environment, but further research using different methods is needed.
Asunto(s)
Imagenología Tridimensional , Tomografía Computarizada Multidetector , Masculino , Femenino , Humanos , Antropología Forense/métodos , Hueso Púbico , HuesosRESUMEN
One of the many challenging cases that forensic pathologists, anthropologists, and forensic imaging experts have to face are burnt human remains. Perpetrators frequently attempt to hide/destroy evidence and make the body unidentifiable by exposing it to fire. We present a case of a partially burnt body found in an apartment after an explosion. First, multidetector computed tomography (MDCT) images and the following autopsy revealed several lesions on the cranium. Forensic anthropologists were involved in order to specify the aetiology of the lesions observed on the cranium. Through an interdisciplinary approach bringing together MDCT scans, 3D surface scans, and anthropological analysis, it was possible to answer the questions raised during the autopsy. Analyses demonstrated that there were signs of blunt force trauma on the cranium vault that the perpetrator likely attempted to hide by exposing the body to fire. This case demonstrates the importance of close collaboration between forensic anthropologists, imaging experts, and forensic pathologists. This multidisciplinary approach allows for a better, more complete reconstitution of forensic cases. Key points: The analyses of burnt human remains are one of the many challenging tasks that forensic pathologists and anthropologists have to face.We present an occurrence of a partially burnt body after an explosion and forensic anthropologists were asked whether the nature of the lesions observed on the cranium could be further specified.Anthropological analyses of the skull were consistent with the radiological and autopsy report. It was possible to reconstruct the various lesions on the dry bone.The case demonstrates the importance of an interdisciplinary approach and the close collaboration between forensic anthropologists, imaging experts, and forensic pathologists.
RESUMEN
Sex estimation is considered one of the first steps in the forensic identification process. Morphological and morphometrical differences between males and females have been used as means for morphoscopic and metric methods on both cranial and postcranial skeletal elements. When dry skeletal elements are not available, virtual data can be used as a substitute. The present research explores 3-dimensional (3D) scans from a Turkish population to test a sex estimation method developed by Purkait (2005). Overall, 296 individuals were used in this study (158 males and 138 females). Purkait's triangle parameters were measured on computed tomography (CT) scans obtained from both right and left femora of each patient at the Bakirkoy Dr. Sadi Konuk Training Research Hospital (Istanbul, Turkey). Intra- and inter-observer errors were assessed for all variables through technical error of measurements analysis. Bilateral asymmetry and sex differences were evaluated using parametric and non-parametric statistical approaches. Univariate and multivariate discriminant function analyses were then conducted. Observer errors demonstrated an overall agreement within and between experts, as indicated by technical error of measurement (TEM) results. No bilateral asymmetries were reported, and all parameters demonstrated a statistically significant difference between males and females. Fourteen discriminant models were generated by applying single and combined parameters, producing a total correct sex classification ranging from 78.4% to 92.6%. In addition, over 67% of the total sample was accurately classified, with 95% or greater posterior probabilities. Our study demonstrates the feasibility of 3D sex estimation using Purkait's triangle on a Turkish population, with accuracy rates comparable to those reported in other populations. This is the first attempt to apply this method on virtual data and although further validation and standardisation are recommended for its application on dry bone, this research constitutes a significant contribution to the development of population-specific standards when only virtual data are available.Key pointsCT analysis using Purkait's triangle is a suitable tool for assessment of sex in unidentified individuals.The best overall estimation rate was achieved with the F11 model, with around 92% of accuracy.The results suggested 78.4% to 92.6% correct sex identification rates.More research is needed to expand the sample set and verify the results.
RESUMEN
During a Disaster Victims Identification (DVI) mission, international protocols rely on interdisciplinary work, especially between specialists from forensic imaging and anthropology. In case of air crashes or explosions, DVI units may face thousands of fragmented human remains (FHRs). The physical re-association of FHRs and the identification process is very complex and challenging, and relies upon expensive and destructive DNA analysis. A virtual re-association (VRA) of these fragments, using Multidetector Computed Tomography (MDCT), could be a helpful tool in forensic anthropology analysis, as it could assist in reducing the number of DNA samples. However, there is no standardized protocol for including such an approach into a DVI procedure. The aim of this study was to summarize and analyze existing techniques through a systematic review and to develop a protocol for virtual re-association of FHRs, adapted to the DVI context. A keyword-based literature search was conducted, focusing on the VRA methods using MDCT imaging and 3D surface scan methodology. Reviews and primary articles, published between 2005 and 2020 in the fields of forensic anthropology, paleoanthropology, archeology, and fracture reduction surgery were sorted out. A total of 45 publications were selected and analyzed based on their content and relevance. The results show that research on the re-association of FHRs increased significantly during the last five years. Seven steps regarding the MDCT-based method for the virtual re-association of FHRs could be identified: acquisition of 3D-images, segmentation of the MDCT-data, post-processing and surface generation, identification of intact and fracture surfaces, identification and registration of matching fragments, and validation of the re-association. The literature is surprisingly sparse regarding the FHRs re-association as a forensic tool, and mainly consists in case reports, whereas validated methods were presented in archeology and surgery publications. However, we were able to adapt the MDCT-based approach for the virtual re-association of the FHRs and propose an innovative protocol for DVI missions. This protocol includes the needed details, from the acquisition of MDCT imaging to the virtual re-association of 3D models and its validation. Each step has to be fully tested, adapted and validated in future studies.
Asunto(s)
Restos Mortales , Víctimas de Desastres , Medicina Legal , ADN , Antropología Forense , HumanosRESUMEN
Sex estimation from skeletal remains is crucial for the estimation of the biological profile of an individual. Although the most commonly used bones for means of sex estimation are the pelvis and the skull, research has shown that acceptable accuracy rates might be achieved by using other skeletal elements such as vertebrae. This study aims to contribute to the development of sex estimation standards from a Turkish population through the examination of CT scans from the seven cervical vertebrae. A total of 294 individuals were included in this study. The CT scans were obtained from patients attending the Bakirkoy Training and Research Hospital (Turkey) and the data was collected retrospectively by virtually taking measurements from each cervical vertebrae. The full database was divided into a training set (N = 210) and a validation set (N = 84) to test the fit of the models. Observer error was assessed through technical error of measurement and sex differences were explored using parametric and non-parametric approaches. Logistic regression was applied in order to explore different combinations of vertebral parameters. The results showed low intra- and inter-observer errors. All parameters presented statistically significant differences between the sexes and a total of 15 univariate and multivariate models were generated producing accuracies ranging from a minimum of 83.30% to a maximum of 91.40% for a model including three parameters collected from four vertebrae. This study presents a virtual method using cervical vertebrae for sex estimation on the Turkish population providing error rates comparable to other metric studies conducted on the postcranial skeleton. The presented results contribute not only to the development of population-specific standards but also to the generation of virtual methods that can be tested, validated, and further examined in future forensic cases.
Asunto(s)
Vértebras Cervicales/anatomía & histología , Determinación del Sexo por el Esqueleto/métodos , Adolescente , Adulto , Vértebras Cervicales/diagnóstico por imagen , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Modelos Estadísticos , Variaciones Dependientes del Observador , Reproducibilidad de los Resultados , Determinación del Sexo por el Esqueleto/estadística & datos numéricos , Tomografía Computarizada por Rayos X , Turquía , Adulto JovenRESUMEN
Since forensic age estimation is not a valid medical indication, research on the use of nonionizing methods is increasing. Ultrasonography is a radiological approach that protects patients from radiation exposure and offers special convenience to them. In this study, ultrasonography was used for age estimation by investigating the degree of ossification of the distal radial epiphysis. Its applicability on the Turkish population was investigated. The left wrist of 688 (322 males, 366 females) patients between the ages of 9 and 25 years was prospectively evaluated by ultrasonography. The intra- and interobserver reliabilities in evaluating the distal radial epiphysis and Cohen's kappa statistics show that the interobserver error was very low, and the kappa value was found to be 0.919. Stage 3 and 4 ossification of the distal radial epiphysis was first detected at age 14.3 and 15.3 years in males and 12.7 and 14.8 years in females, respectively. The data obtained may help determine legally critical age limits of 14 and 15. Although it does not seem useful for the age of 18, ultrasonography may be recommended in selected cases as a fast, inexpensive, frequently reproducible radiological method without concern about radiation and without a predictable health risk.
Asunto(s)
Determinación de la Edad por el Esqueleto/métodos , Osteogénesis , Radio (Anatomía)/diagnóstico por imagen , Muñeca/diagnóstico por imagen , Adolescente , Niño , Epífisis/crecimiento & desarrollo , Femenino , Humanos , Masculino , Estudios Prospectivos , Turquía , Ultrasonografía , Adulto JovenRESUMEN
Radiation exposure is a crucial factor to consider in forensic age estimation. The various magnetic resonance imaging (MRI) modalities used in forensic age estimation avoid radiation exposure. This study examined the reliability of distal radius ossification using fast spin-echo proton density (FSE PD)-weighted MRI to estimate age. Left wrist MRI findings of 532 patients aged 10-29 years were evaluated retrospectively using the five-stage system of Dedouit et al. The intra- and interobserver reliability values were κ = 0.906 and 0.869, respectively. Based on the results, the respective minimum ages estimated for stages 4 and 5 were 13.4 and 16.1 years for females, and 15.1 and 17.3 years for males; the method could not estimate an age of 18 years in any case. FSE PD MRI analysis of the distal radius epiphysis provides supportive data and can be used when evaluating the distal radius for forensic age estimation.
Asunto(s)
Determinación de la Edad por el Esqueleto/métodos , Imagen por Resonancia Magnética/métodos , Osteogénesis , Radio (Anatomía)/diagnóstico por imagen , Muñeca/diagnóstico por imagen , Adolescente , Adulto , Niño , Epífisis/diagnóstico por imagen , Femenino , Humanos , Masculino , Estudios Retrospectivos , Adulto JovenRESUMEN
The evaluation of epiphyseal areas by magnetic resonance imaging (MRI) for forensic age estimation is an important supportive diagnostic method to prevent repeated radiation exposure without a valid medical reason. There are still not enough individuals being analyzed with MRI for age estimation. The aim of this study was to investigate the utility of T1-weighted turbo spin echo (T1-TSE) MRI sequences in determining the degree of ossification of the distal femoral and proximal tibial epiphyses in a Turkish population. In this study, images from 649 patients (335 males and 314 females) aged 10-30 years were retrospectively evaluated with sagittal T1-weighted turbo spin echo (T1-TSE) MRI sequences of the knee. Proximal tibial and distal femoral epiphysis were scored by two different observers twice using the combined staging system described by Schmeling and Kellinghaus. Spearman's rank correlation analysis indicated a significant positive relationship between age and ossification stages of the distal femoral and proximal tibial epiphyses (p < 0.001). The intra- and inter-observer reliabilities in evaluating the femur and tibia were separately determined and gave promising results and Cohen's kappa statistics ranged from κ = 0.886 and κ = 0.961. The minimal ages of patients with stage 4 ossification were 15.1 years for females and 15.8 years for males for the distal tibial epiphysis and 15.4 years for females and 17 years for males for the distal femoral epiphysis. This study show that (T1-TSE) MRI and the applicability and Schmeling and Kellinghaus staging method of the knee can be performed for living 14- to 17-year-old individuals in need of a supportive noninvasive method for estimating forensic age.
Asunto(s)
Determinación de la Edad por el Esqueleto , Epífisis/diagnóstico por imagen , Fémur/diagnóstico por imagen , Rodilla/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Osteogénesis/fisiología , Tibia/diagnóstico por imagen , Adolescente , Adulto , Niño , Epífisis/crecimiento & desarrollo , Femenino , Fémur/crecimiento & desarrollo , Humanos , Masculino , Tibia/crecimiento & desarrollo , Turquía/epidemiología , Adulto JovenRESUMEN
Virtual anthropology (VA) is based on applying anthropological methods currently used to analyse bones to 3D models of human remains. While great advances have been made in this endeavour in the past decade, several interrogations concerning how reliable these models are and what their proper use should be remain unanswered. In this research, a fundamental assumption of VA has been investigated: if the way we perceive and apply an anthropological method is truly similar when looking at bones macroscopically and through various 3D media. In order to answer, 10 skulls of known age and sex were scanned using a computed tomography (CT) scanner and a 3D surface scanner. Two observers separately applied a defined staging method to eight suture sites on these skulls, first looking at the bone macroscopically, then at the 3D surface scan, and finally on the CT scan. Two rounds of observation were carried out by each observer. Intra- and inter-observer error were evaluated, and two sample t-tests used to evaluate if the different types of medium used yielded significantly different observations. The results show a high degree of inter-observer error, and that data obtained from 3D surface scans differ from macroscopic observation (confidence level 95%, P ≤ 0.05). CT scans, in these settings, yielded results comparable to those obtained through macroscopic observations. These results offer many possibilities for future research, including indications on the kind of anthropological methods and anatomical landmarks that might be reliably transferable to the virtual environment. All current methods used in traditional anthropology should be tested, and if they prove unreliable, new techniques to analyse bones from virtual models should be developed.Key pointsLarge discrepancies between observation on dry bones and computer-generated 3D models (surface scans or CT scans) could lead to the re-evaluation of the suitability of traditional anthropological methods for application on 3D models.This preliminary study evaluates whether macroscopic, 3D surface scans, and CT scans viewings generate different observations.The results indicate that the data are not always coherent across all three media of observation.Explanations include the aspect given to the bone by the 3D software, differences between handling bones in real life versus on a computer, and level of expertise of the observers.
RESUMEN
OBJECTIVES: Stable isotope analysis has often been used in neonatal remains from archeological contexts to investigate the presence of a signal of breastfeeding and weaning in past populations. Tooth histology on the other hand might be used as an indicator of birth survival. This pilot study aimed to investigate the feasibility of using stable nitrogen (δ15 N) and carbon (δ13 C) isotope values from neonatal bone collagen to elucidate if values deviating from the adult female average could indicate breastfeeding and co-occur with the presence of a neonatal line (NNL). The combination of these independent indicators might be useful in clarifying the fate of individuals who died around birth. MATERIALS AND METHODS: Bone collagen from 21 archeological human and animal specimens was extracted and analyzed via mass-spectrometry for δ15 N and δ13 C. A verification of the stable isotope results was undertaken using tooth histology on three individuals who were investigated for the presence of a NNL as an indicator of live birth and short survival. RESULTS: The biological age of the human samples varied between 8.5 lunar months (Lm) and 2 postnatal months (Pm) of age. All except one individual exhibited elevated δ15 N values compared to the female average. The histological analyses revealed no NNL for this and two further individuals (n = 3). DISCUSSION: The results indicate that elevated nitrogen values of very young infants relative to a female average in archeological contexts are not necessarily associated with a breastfeeding onset signal, and therefore cannot be used exclusively as a proxy of birth survival. The elevation might be possible due to various reasons; one could be nutritional, in particular maternal stress during pregnancy or a metabolic disorder of mother and/or her child. In those cases, the evaluation of a NNL might reveal a false breastfeeding signal as seen for two individuals in our sample who have elevated nitrogen values despite the fact no NNL could be observed. Overall, our data support the growing awareness that bone collagen δ15 N values of neonates/infants should not be used as a proxy for breastfeeding or birth survival on its own.
Asunto(s)
Lactancia Materna , Isótopos de Carbono/análisis , Colágeno , Esmalte Dental/anatomía & histología , Isótopos de Nitrógeno/análisis , Animales , Antropología Física , Colágeno/análisis , Colágeno/química , Femenino , Fémur/química , Humanos , Lactante , Recién Nacido , Modelos Estadísticos , Embarazo , Mortinato , Diente/químicaRESUMEN
Jörg Jenatsch, a leading freedom fighter during the Thirty Year's War in Graubünden, Switzerland, was assassinated on carnival 1639. Jenatsch's controversial biography and the unclear circumstances of his death inspired the formation of various legends, novels and films. In 1959, a skeleton discovered in the cathedral of Chur with remains of wealthy baroque clothing was tentatively attributed to Jenatsch. Here, we reassess the skeleton based on a new exhumation. Our multidisciplinary analysis and the head injuries are consistent with reports of the eyewitnesses of the crime, demonstrating that Jenatsch was killed from behind with a semi-sharp implement, supposedly an axe, as well as by a blow with a broad-surfaced object. Moreover, our facial reconstruction closely matches an oil portrait of Jenatsch, and the HIrisPlex system applied to DNA-extracts from the femoral bone reveals brown eye and dark brown hair colour, which coincides well with the portrait, too. Finally, isotope analysis of the femoral bone and a molar support Jenatsch's high social status, luxury diet and a high mobility in the last decade of his life. This multidisciplinary approach thus reinforces personal identification and provides additional insight into the life of this important historic person beyond written resources.
Asunto(s)
Antropología Forense , Homicidio , Adulto , ADN/análisis , Exhumación , Color del Ojo , Cara , Femenino , Color del Cabello , Humanos , Isótopos/análisis , Masculino , Cráneo/lesiones , Suiza , Adulto JovenRESUMEN
Trepanation is defined as the intentional perforation of the cranial vault with removal of a piece of skull bone. In Europe, trepanation is known to have been practiced at least since the Neolithic, and it can still be found today in East African native tribes. Two skulls with lesions from the Late Iron Age site Münsingen-Rain (420-240 BC) were investigated. The aim of this study was to analyse the lesions and to determine whether they were caused by surgical interventions. Both individuals were analysed by current morphologic-anthropological methods and radiological examinations were performed with a multislice CT-scanner. Additionally, this work surveys trepanations reported in Switzerland and calculates survival rates. In Switzerland, 34 individuals with trepanations have been published. As a tendency, the survival rate appears to be relatively high from the Neolithic to Late Antiquity but then decreases until Pre-Modern times. The 78% survival rate in Late Iron Age Switzerland indicates that the surgery was often performed successfully. Skull injuries sustained in conflicts could have been a reason for trepanation during the Iron Age.
RESUMEN
The gladiator cemetery discovered in Ephesus (Turkey) in 1993 dates to the 2nd and 3rd century AD. The aim of this study is to reconstruct diverse diet, social stratification, and migration of the inhabitants of Roman Ephesus and the distinct group of gladiators. Stable carbon, nitrogen, and sulphur isotope analysis were applied, and inorganic bone elements (strontium, calcium) were determined. In total, 53 individuals, including 22 gladiators, were analysed. All individuals consumed C3 plants like wheat and barley as staple food. A few individuals show indication of consumption of C4 plants. The δ13C values of one female from the gladiator cemetery and one gladiator differ from all other individuals. Their δ34S values indicate that they probably migrated from another geographical region or consumed different foods. The δ15N values are relatively low in comparison to other sites from Roman times. A probable cause for the depletion of 15N in Ephesus could be the frequent consumption of legumes. The Sr/Ca-ratios of the gladiators were significantly higher than the values of the contemporary Roman inhabitants. Since the Sr/Ca-ratio reflects the main Ca-supplier in the diet, the elevated values of the gladiators might suggest a frequent use of a plant ash beverage, as mentioned in ancient texts.
Asunto(s)
Arqueología , Dieta , Isótopos , Oligoelementos , Huesos/química , Conducta Alimentaria , Femenino , Geografía , Humanos , Masculino , TurquíaRESUMEN
In this study we present the analysis of the human remains from tomb K93.12 in the Ancient Egyptian necropolis of Dra' Abu el-Naga, located opposite the modern city of Luxor in Upper Egypt on the western bank of the Nile. Archaeological findings indicate that the rock tomb was originally built in the early 18th dynasty. Remains of two tomb-temples of the 20th dynasty and the looted burial of the High Priest of Amun Amenhotep have been identified. After the New Kingdom the tomb was reused as a burial place until the 26th dynasty. The skeletal and mummified material of the different tomb areas underwent a detailed anthropological and paleopathological analysis. The human remains were mostly damaged and scattered due to extensive grave robberies. In total, 79 individuals could be partly reconstructed and investigated. The age and sex distribution revealed a male predominance and a high percentage of young children (< 6 years) and adults in the range of 20 to 40 years. The paleopathological analysis showed a high prevalence of stress markers such as cribra orbitalia in the younger individuals, and other pathological conditions such as dental diseases, degenerative diseases and a possible case of ankylosing spondylitis. Additionally, 13 mummies of an intrusive waste pit could be attributed to three different groups belonging to earlier time periods based on their style of mummification and materials used. The study revealed important information on the age and sex distribution and diseases of the individuals buried in tomb K93.12.
Asunto(s)
Huesos/patología , Entierro/historia , Momias/historia , Momias/patología , Adolescente , Adulto , Niño , Preescolar , Antiguo Egipto , Femenino , Historia Antigua , Humanos , Hiperostosis/patología , Lactante , Masculino , Persona de Mediana Edad , Órbita/patología , Paleopatología , Adulto JovenRESUMEN
The single Hochdorf burial was found in 1887 during construction work in the Canton of Lucerne, Switzerland. It dates from between 320 and 250 BC. The calvarium, the left half of the pelvis and the left femur were preserved. The finding shows an unusual bony alteration of the skull. The aim of this study was to obtain a differential diagnosis and to examine the skull using various methods. Sex and age were determined anthropologically. Radiological examinations were performed with plain X-ray imaging and a multislice computed tomography (CT) scanner. For histological analysis, samples of the lesion were taken. The pathological processing included staining after fixation, decalcification, and paraffin embedding. Hard-cut sections were also prepared. The individual was female. The age at death was between 30 and 50 years. There is an intensely calcified bone proliferation at the right side of the os frontalis. Plain X-ray and CT imaging showed a large sclerotic lesion in the area of the right temple with a partly bulging appearance. The inner boundary of the lesion shows multi-edged irregularities. There is a diffuse thickening of the right side. In the left skull vault, there is a mix of sclerotic areas and areas which appear to be normal with a clear differentiation between tabula interna, diploë and tabula externa. Histology showed mature organised bone tissue. Radiological and histological findings favour a benign condition. Differential diagnoses comprise osteomas which may occur, for example, in the setting of hereditary adenomatous polyposis coli related to Gardner syndrome.