Vertebral haemangioma in a Roman period skeleton from the Dakhleh Oasis, Egypt. (1st April 2020)

• Record Type: Journal Article
• Authors: Molto, Joseph E.; Chhem, Rethy; Maxwell, Jay; Teeter, Mathew A.; Sanchez, Jose; Holdsworth, Dave
• Is Part Of: International journal of osteoarchaeology. Volume 30:Number 4(2020)
• Page Start: 417
• Page End: 424
• Publication Date: 2020-04-01
• Subjects: Dakhleh Oasis -- haemangioma -- human skeleton -- microcomputed tomography -- palaeoepidemiology -- palaeopathology -- radiology -- vertebra; Physical anthropology -- Periodicals; Human remains (Archaeology) -- Periodicals; Paleopathology -- Periodicals; Paléontologie -- Périodiques; Paléopathologie -- Périodiques; Anthropologie physique -- Périodiques; 930.10282
• DOI: 10.1002/oa.2868
• Languages: English
• ISSNs: 1047-482X

Abstract

Abstract: A 50‐ to 65‐year‐old female, from the Roman period Kellis 2 (K2) cemetery in the Dakhleh Oasis, Egypt, shows macroscopic and imaging evidence of a vertebral haemangioma (VH). The centrum of the 12th thoracic vertebrae has an expanded and lysed cortex and thickened vertical trabeculae—producing the pathognomonic "corduroy" radiological sign. Additionally, the first lumbar vertebrae shows early changes of haemangioma that are not obvious macroscopically but clear on the X‐ray and the microcomputed tomography (μCT) imaging. VHs are relatively common (>10%) benign vascular tumours in extant adult populations. Its rarity in antiquity can be explained by the fact that in most archaeological samples, haemangiomas would not be macroscopically visible because the destruction and expansion of the cortex only occurs in advanced cases (usually in older individuals). In archaeological populations, older individuals (60+), though present, are much less common, and hence, the prevalence of VHs would be much lower than that reported in modern clinical samples. We posit that in order to determine the approximate prevalence of VHs in antiquity, a systematic radiographic study of an entire adult archaeological population sample is required. A caveat to this problem is that radiological diagnosis is difficult unless at least one third of the centrum is involved, and the classic radiological signs are manifested. A review of case studies suggest that X‐rays from T4 to L4 would include ~95% of the potential cases of VHs, and if a portable μCT unit can be developed, the natural history of VHs will be better established.