Meningiomas in Ancient Human Populations.

Della Collins Cook,Marie Elaine Danforth

doi:10.3390/cancers14041058

Meningiomas in Ancient Human Populations.

Della Collins Cook, Marie Elaine Danforth

Open Access

https://doi.org/10.3390/cancers14041058

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Abstract

Simple SummaryMeningiomas are the most common tumor of the central nervous system but are rare in the paleopathological record. Although they are technically a soft tissue phenomenon, they do leave various lesions on the skeletons, including thickened bone adjacent to the tumor and vascular impression changes. A review of the literature of health in past populations revealed some 43 cases of lesions identified by the original authors as meningioma. These cases are considered in terms of the appearance of the lesions as well as alternative diagnoses. The age distribution fits modern demographic patterns for meningioma patients but the sex distribution is roughly opposite of current patterns. It is suggested that meningiomas should be considered more often in differential diagnoses in ancient people.Meningiomas are the most common tumor of the central nervous system and can result in skeletal manifestations, including hyperostosis of the adjacent cranial bone, enostoses, depressions, and enhanced vascular impressions. However, their identification in the paleopathological literature has been rare and few cases have received broad acceptance of the diagnosis. A review of the literature identified some 43 cases in which individuals were argued to have suffered from meningiomas. Most were seen in older individuals but were more likely to affect males. Eleven individuals exhibited hyperostosis, the most easily recognized indicator, usually located on the parietal bone; the hyperostotic region averaged 8 cm in diameter and 3.0 cm in height. Seven displayed lytic lesions with areas much smaller in size than the hyperostosis, and many had vascular changes. The other cases had indicators that varied greatly in terms of location and expression and included both sclerotic lesions and hollow areas. Several authors also suggested other possible causes of the lesions. The findings reflect the non-pathognomonic nature of the effects of meningiomas. However, given their likely frequency and potentially severe effects in ancient people, it is argued that they should be taken into consideration more frequently when performing differential diagnoses.

Highlights

Many contributors to the paleopathology and history of medicine argue that cancer is a disease of civilization and that tumors—malignant and benign—are only a recent burden on human health
These claims are problematic for many reasons [1], but meningiomas are an interesting exception to this supposed rule
No modern mortality rates associated with untreated meningiomas could be identified because they are so amenable to surgery, Aufderheide and Rodríguez-Martín [2] (p. 251) have suggested that many such tumors would have resulted in death in the past, even if, like most modern meningiomas, they are not malignant

Summary

Introduction

Many contributors to the paleopathology and history of medicine argue that cancer is a disease of civilization and that tumors—malignant and benign—are only a recent burden on human health. Campillo [4] has created an eight-point scale of bone lesions associated with meningomas that includes increased vascularization, lytic destruction, and thickening of cranial tables Assuming they were the most common tumor of the central nervous system (CNS) in the past as they are today [5], meningiomas have been less commonly identified by paleopathologists than one might expect, despite the fact that an appreciable frequency of cases does leave skeletal lesions. Neurosurgeon Harvey Cushing’s 1922 characterization of meningioma [8] and archaeologist George Grant MacCurdy’s [9] near-simultaneous discovery of a case from Paucarcaucha in ancient Peru are incorrectly linked in some sources on the history of paleopathology This iconic case was identified by MacCurdy as an osteosarcoma. Conspicuous in their absence, viral infections are not implicated in the etiology of meningioma, and we cannot deploy the interesting argument that such cancers ought to have been more common in the past than they are in the present [1]

Diagnoses of Meningiomas in the Past

Data Collection and Analysis

Findings

Conclusions