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Probable destructive meningioma in an archaeological adult male skull from Alaska
Birna Jónsdóttir1, Donald J Ortner, Bruno Frohlich
1Röntgen Domus Medica, Reykjavik, Iceland.
Abstract:
Several intracranial pathological conditions can affect the bones of the skull. The most common cause of these conditions is tumor, but infection and other diseases are also known to affect the bones of the skull. Distinguishing between the various causes of intracranial skeletal pathology in archaeological human remains is usually a challenging exercise, and a specific diagnosis will often be impossible. Meningiomas are tumors that arise in arachnoid tissues embedded in the outer layer of the dura. Because of this association, they occur almost exclusively in the skull and vertebral column. Usually meningiomas are slow-growing tumors that do not metastasize to other organs and tissues of the body. However, rare cases can be malignant and, even when meningiomas are benign, their presence and growth can adversely affect the nervous and vascular supply to other tissues in the skull and vertebral column. Their effect on adjacent bone tissue varies from stimulating bone-forming lesions to causing highly destructive lesions. A few examples of meningioma have been described in the paleopathological literature. Most of these cases are bone-stimulating meningiomas. The case presented here is a probable example of a highly destructive meningioma of the skull base, with unilateral extension into the left side of the cranium. This case is compared with a modern clinical case of destructive intracranial meningioma that was documented both radiographically and pathologically. Destructive meningiomas can be confused with other pathological conditions, including benign and malignant tumors. Criteria for differentiating the diagnostic options are reviewed.
Insights
This study presents a rare case of a destructive meningioma in ancient skull remains, highlighting diagnostic challenges in paleopathology. Comparing it to a modern case, it reviews criteria for differentiating such bone lesions.
Area of Science:
- Paleopathology
- Neurosurgery
- Skeletal Biology
Background:
- Intracranial pathological conditions, primarily tumors, infections, and other diseases, can affect skull bones.
- Meningiomas, tumors arising from arachnoid tissues, predominantly occur in the skull and vertebral column.
- These tumors can range from benign to malignant, causing bone-stimulating or destructive lesions.
Purpose of the Study:
- To present a probable case of a highly destructive meningioma in archaeological human remains.
- To compare this paleopathological case with a modern clinical case of destructive intracranial meningioma.
- To review diagnostic criteria for differentiating destructive meningiomas from other cranial pathologies.
Main Methods:
- Analysis of a probable destructive meningioma case from archaeological human remains.
- Radiographic and pathological documentation of a modern clinical case of destructive intracranial meningioma.
- Comparative review of diagnostic criteria for skull base and cranial pathologies.
Main Results:
- A rare case of a destructive meningioma affecting the skull base with cranial extension was identified in paleopathological samples.
- The paleopathological case exhibits destructive bone lesions, contrasting with more commonly reported bone-stimulating meningiomas in literature.
- Comparison with a modern case aids in understanding the radiographic and pathological features of destructive meningiomas.
Conclusions:
- Distinguishing intracranial skeletal pathologies in archaeological remains is challenging, with specific diagnoses often difficult.
- Destructive meningiomas represent a significant paleopathological finding that can be mistaken for other tumors or diseases.
- Establishing clear diagnostic criteria is crucial for accurate identification of destructive meningiomas in historical and modern contexts.
