The Role of Forensic Autopsies in Diagnosis of Cancer

Abstract

Background: Death from cancer is mostly considered as natural deaths. The role of cancer on the cause of death in forensic cases like sudden deaths, negligence or malpractice claims are being investigated. In a small amount of forensic cases, cancer is found incidentally at the autopsy. The aim of this study was to reveal characteristics of the cases in which cancer was diagnosed and types of malignancies in medicolegal autopsies. In addition, the role of forensic autopsies in determining oncological diseases was discussed.Methods: Forensic autopsies were performed in the Morgue Department of Forensic Medicine Council in İzmir for eight years were retrospectively reviewed. Cases that postmortem histopathological examination performed and malignant tumors diagnosed were included in the study. Data about age, sex, location of tumors, immediate causes of death and the potential relation between tumors and the primary cause of death were investigated.Results: In eight year period (between 2001 and 2009), 3722 medicolegal autopsies were done by postmortem histopathological examination. In 86 cases such kind of tumors were observed. In seven of 86 cases the tumors were determined as benign and excluded from the study. The remaining 79 cases with malignant tumors included in the study, 63 (79.7%) were male and 16 (20.3%) were female, mean age 54.96±20.35 (range: 7-88 years). The tumors were most frequently located in respiratory system (35.4%), gastrointestinal system (19%), genitourinary system (10.1%) and central nervous system (8.9%). The males most frequently had tumors in the respiratory system (42.9%) and the females in the endocrine system (25%). According to histopathological classification of the tumors, the most frequent tumors were epithelial tumors (65.8%), followed by hemopoetic (12.7%), mesenchymal (7.6%), glial (5.1%) and neuroendocrine tumors (2.5%) and timoma (1.3%). The tumors could not be histopathologically differentiated in 5.1% of the deaths. Cause of death was considered as cancer related complications in 58 cases (73.4%), other natural causes in 6 cases (7.6%) and external factors such as traumas and intoxications in 10 cases (12.7%). The cause of could not determined following complete autopsy and postmortem investigation in 5 cases (6.3%).Conclusion: Providing accurate cancer statistics by only clinical trials or medical autopsies that are diminished nowadays and clinical cancer outputs seems to be inadequate. We participated that investigating malignancies in large series of forensic autopsies would be contributed to data about public health.Keywords: cancer, medicolegal autopsy, cause of death