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The cutaneous cancer of Ferdinando Orsini, 5th Duke of Gravina (death in 1549)
Full text linkThe natural mummy of Ferdinando Orsini, Duke of Gravina in Apulia (southern Italy), dead in 1549 at about 50-55 years of age, showed the face completely covered by a veil and two small patches of cloth at the root of the nose and in the right orbit. After removal of the veil and the patches, surely a medical dressing, an extensive and destructive lesion of the right orbit and the root of the nose appeared. The lesion revealed, at macroscopic examination, complete destruction of the right and root of the left nasal bone, destruction of the medial wall of the right orbit with extensive erosion of the glabellar region and the upper third of the vomer.
X-ray examination of the facial skull showed a large, irregular loss of bone, extending from the inner corner of the right orbit, near the root of the nose, towards the frontal bone, with total involvement of the right and partial of left sinuses and the ethmoid, without any sclerotic reaction. Total body X-ray did not reveal any other osteolithic lesion.
Histology of eroded fragments of the vomer and left nasal bone showed largelacunae with clear borders, surrounded by other smaller round lacunae, destructing the normal lamellar bone, sometimes containing clusters of partially necrotic cells with solid epithelial-like aspects(Fig. 7a, b), well visible in particular inside one of the largest lacunae.The border between the bone and the underlying tissue in lacunae is clear and sharp and the brownish like-epithelial mass reveals a darker margin (looking like a palisade) and it is separated from the bone by clefting artifacts.The epithelial origin of the cells of the osteolytic lesion was confirmed by the strong positivity for pancytokeratin.
The lesion of the facial skull of Ferdinando Orsini is macroscopically and microscopically suggestive of a diagnosis of destructive basal cell carcinoma in advanced stage of evolution (Fornaciari et al., 1989; Gaeta et al., 2015).
This tumor, histologically characterizedby a front of neoplastic invasion with cells arranged in a palisade and cleft-like retraction spaces of artefactual nature, has a strong local aggressiveness and cause skin ulceration and bone destruction (hence the Latin name of ‘ulcus rodens’), without remote metastases, is also at present one of the most common malignant skin neoplasms, caused by exposure to sunlight.
Literature cited
Fornaciari G, Bruno J, Corcione N, Tornaboni D, Castagna M: Un cas de tumeur maligne primitive de la region naso-orbitairedansunemomie de la basilique de S. Domenico Maggiore à Naples (XVIe siècle); in Capasso L (ed): Advances in Paleopathology: Proceedings of the VII European Meeting of the Paleopathology Association: Lyon, September 1988. J PaleopatholMonogrPubl. Chieti, Solfanelli, 1989, pp 65–69.
Gaeta R, Ventura L, Fornaciari G: Il tumore di Ferdinando Orsini, duca di Gravina di Puglia (+1549); in Atti del 50° Congresso Nazionale della Società Italiana di Storia della Medicina, Palermo 2-4 ottobre 2014. Palermo 2015, pp. 189-194
Ancient DNA and paleogenetics: Risks and potentiality
No full textPaleopathology, the science that studies the diseases of the past, has always been addressed to the future in the use of new diagnostic methods. One of its relatively recent branches is paleogenetics, which is the study of genetic material from the past. Nuclear and mitochondrial DNA recovered from archaeological and paleontological specimens is called ancient DNA (aDNA), which can be extracted from a large variety of biological materials, of different origin, state of preservation and age, such as bones, teeth, coprolites, mummified tissues and hairs. There are many applications for ancient DNA research in the field of archaeology and paleopathology: population demography, genealogy, disease studies, archaeological reconstruction of plant vegetation, calibration of the molecular clock, phylogenetic relationship between different mammals and interpretation of the paleoclimate. However, the study of ancient genetic material is extremely difficult due to its poor quality and quantity, as well possible contamination with modern DNA. New advanced methods will allow extracting DNA from a greater variety of materials, and improvements in sequencing techniques will unveil data that are currently concealed. The aim of this paper is to provide initial insights into paleogenetics and ancient DNA study and to illustrate the limits, risks and potentiality of the research on the genetic material of ancient specimens, whose results have a strong impact on the present and future medicine
Necropsy reports and anatomo-pathological observations from the archives of the Grand Ducal Medici family of Florence. Part I - The 16th century
Full text linkDuring the Renaissance and Early Modern Age dissection began to be practiced for medico-legal
purposes, in order to investigate the causes of death. In particular, during the 15th century evidences of autopsies
performed by doctors on their private patients emerge. These dissections were requested by those families
who can afford the expenses, in order to search the possible presence of hereditary diseases and to predispose
a prevention and cure. The diffusion of this practice is attested also by the work of Antonio Benivieni (1443-
1502), who is considered a pioneer of the pathological anatomy. The extremely rich documentary archives
of the Medici family, one of the most important family of the Italian Renaissance, report several description
of necropsies carried out on the bodies of the members of the family. The analysis of these reports offers
important direct information on the autopsy practices performed by court surgeons of the members of an
aristocratic class in a period comprised between the 16th and the first half of the 18th century, and allows in
some cases also to propose a retrospective diagnosis on the diseases that afflicted the Medici. In this paper
the analysis will be focused on the evidences about autopsies carried out during the 16th century. An evolution
through time can be observed, as from the first very brief notes at the beginning of the period the reports
become more detailed and accurate at the end of the century
Necropsy reports and anatomo-pathological observations from the archives of the Grand Ducal Medici family of Florence. Part II – The 17th and first half of the 18th century
Full text linkDuring the Modern Age, dissection began to be practiced for medico-legal purposes, in order to investigate the causes of death. In particular, starting from the 15th century evidences of autopsies performed by doctors on their private patients emerge. These dissections were requested by those families who can afford the expenses, in order to search the possible presence of hereditary diseases and to predispose a prevention and cure. The extremely rich documentary archives of the Medici family, one of the most important family of the Italian Renaissance, report several description of necropsies carried out on the bodies of the members of the family. The analysis of these reports offers important direct information on the autopsy practices performed by court surgeons of the members of an aristocratic class in a period comprised between the 16th and the first half of the 18th century, and allows in some cases also to propose a retrospective diagnosis on the diseases that afflicted the Medici. Following a previous work that discussed the evidences dated back to the 16th century, this paper will be focused on the reports about autopsies carried out during the 17th and the first half of the 18th century. During this period, the reports became more accurate and detailed, reaching at the end of the period the characteristic of modern scientific autopsy notes. Therefore, in the majority of cases the lesions referred by the court physician provide sufficient element to propose a retrospective diagnosis based on the symptoms referred by the historical sources during the life of the patients and on the cadaveric examination
Disseminated cystic echinococcosis of Ferdinando II de’ Medici, Grand Duke of Tuscany (1610-1670)
No full textThe article examine the necroscopic report of Ferdinando II de' Medici performed in 1670, from which a diagnosis of disseminated cystic echinococcosis can be formulated
Paleopathological and metagenomic study of a XIIth cetury Perucian mummy: an ancient case of Chagas disease
Full text linkAmong the results obtained from this study there is the only known complete paleopathological study of Chagas’ disease (American Trypanosomiasis), comprising macroscopic, microscopic and ultrastructural data, as well as information on atherosclerosis, anthracosis, emphysema and pneumonia. We characterized the gut microbiome of two pre-Columbian Andean mummies dating to the 10–15th centuries using 16S rRNA gene high-throughput sequencing and metagenomics, and compared them to a previously characterized gut microbiome of an 11th century AD pre-Columbian Andean mummy. Our previous study showed that the Clostridiales represented the majority of the bacterial communities in the mummified gut remains, but that other microbial communities were also preserved during the process of natural mummification, as shown with the metagenomics analyses. Metagenome analyses showed the presence of other microbial groups that were positively or negatively correlated with specific metabolic profiles. The presence of sequences similar to both Trypanosoma cruzi and Leishmania donovani could suggest that these pathogens were prevalent in pre-Columbian individuals
ATHEROSCLEROSIS IN THE ITALIAN MUMMIES (15TH-20TH CENTURY)
No full textAtherosclerosis, disease in which the lumen of an artery nar-rows up to occlusion caused by buildup of plaque composed of fatty material on the inner walls, is one of the most com-mon pathology among the developed countries and every year thousands of people die by the complications of the atherosclerotic disease (in Central Europe: 201 man and 117 women per 100,000 inhabitants per year 1). Due to its connec-tion with the dietary habits, the disease had been considered peculiar of the modern sedentary and well-nourished society, with diet characterized by a rich intake of meat, sugar and fat. However, the presence of atherosclerosis in mummies of different temporal horizons and different geographic contexts 2]suggests the potential that other risk factors or causes could result in atherosclerosis.We report the results of the macroscopic and histologic studies performed on six Italian mummies from different regions and belonging to a wide range of time. The oldest subject is Oetzi, the so-called Iceman, a natural mummy of the Copper Age (3300-3100 BC) whose atherosclerotic disease has also been investigated from a genetic point of view 3. Ferrante I of Aragon, king of Naples (1423-1494 CE) suffered the consequences of a excessive and unregulated diet 4. Girolamo Macchi (1649-1734 CE), Major Writer of Santa Maria della Scala Hospital of Siena, died at an advanced age and evident traces of atherosclerotic calcifications are present along the abdominal aorta. Two mummies with atherosclerosis have been found in Comiso, Sicily, and belonged to two subjects who lived in the 18th and 19th centuries and died respectively at 50 and 30 years. Finally, the most recent mummy (20th century) comes from Abruzzo and belonged to an unidentified individual of the poor class. The problem of atherosclerosis in Antiquity is a topic that has aroused much debate in recent times. Besides being a fascinating field of research, it has an important impact on modern medicine since atherosclerosis is among the most widespread pathologies in Western populations. The six investigated mummies have unequivocal findings attributable to atherosclerosis in varying degrees of severity. In some cases, the diagnosis was macroscopic, while for some mummies it was possible to perform histologic analyses of the arterial vessels. In conclusions these cases confirm that atherosclerosis is also a disease of ancient times. The presence of atherosclerosis in pre-contemporary individuals could suggest that the disease may not only be uniquely characteristic of a specific diet or lifestyle, but it could be also an inherent component of human ageing. Additional future surveys will help to clarify the history of this disease
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