Metastatic cancer and endentulism: Exploring comorbidity to assist with differential diagnosis in a case from Vico nel Lazio (Fr, Italy), 13th-15th century CE.

OBJECTIVE: To differentially diagnose cranial lesions noted on a medieval skeleton and explore the importance of comorbidity. MATERIALS: A skull of an adult female with osteolytic and osteoblastic lesions, edentulism, and an ectopic tooth from an ossuary of the Church of Santa Maria in Vico del Lazio, Frosinone Italy, dating to the Middle Ages. METHODS: Macroscopic observations of the remains, CT scan, and differential diagnosis was undertaken. RESULTS: A diagnosis of metastatic cancer (potentially breast cancer) or metastatic neuroblastoma (NBL) is offered. CONCLUSIONS: Considering the noted comorbidities, this case might represent a rare case of metastatic neuroblastoma. SIGNIFICANCE: The exploration of comorbidity, in this case the presence of metastatic carcinoma and edentulism, has tremendous potential to expand our knowledge about cancer in the past. LIMITATIONS: Lack of postcranial elements. SUGGESTIONS FOR FURTHER RESEARCH: Clinical and paleopathological investigation of comorbidity in modern and archeological populations to develop an evolutionary perspective on the presence of cancer in the past.

Biological history of an Italian prehistoric community and the population of the central Italy during the 1st millennium BCE.

Understanding the population of Central Italy during the 1st millennium BCE is a crucial topic in the biological history of the Mediterranean basin. This period saw the emergence of the Etruscan and Roman cultures which had a significant impact on the bio-cultural history of the region. In this study, we analyse a prehistoric population from Caracupa (Iron Age, Latium, Central Italy). The results suggest an overall good level of health for the population. Despite this, some musculoskeletal changes related to biomechanical stressors were observed, probably as the result of strenuous physical activity. The results of a Simple Matching analysis of intragroup distance distributions suggest potential model of kinship structures and lineages. This may be due to the relative geographic isolation of the Caracupa population. Furthermore, in order to investigate the wider population of Central Italy during the 1st millennium BCE, we have constructed a population pattern using genetic and phenotypic skeletal and dental traits. The comparison between Central Italy and more isolated populations indicated a divergence between the Western and Eastern sides of Central Italy. However, we do not exclude a probable common genetic substratum for all Central Italian populations during the 1st millennium BCE.

A case of cervical rib andneurovascular compression inRoman period

The possibility to study axial anomalies directly on a skeletal individual is not very frequent. One well preserved skeletal individual from an Italian site dating to the late antique period (5th -4th centuries CE) was studied. This individual shows some interesting skeletal changes in the vertebrae and ribs. A supernumerary rib was found. It is a cervical rib connected to the 1st thoracic rib, presumably with a fibrous bundle. The presence of cervical ribs can produce neurovascular compression of the brachial plexus and subclavian vessels. Because of this, it is often a cause of thoracic out-let syndrome (TOS). In our case the presence of a cervical rib articulated with the first thoracic rib through a probable fibrous band could have re-stricted the space where the brachial plexus and subclavian vessels pass through, creating a state of neurovascular compression, similar

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