Paleopathological Description and Diagnosis of Metastatic Carcinoma in an Early Bronze Age (4588+34 Cal. BP) Forager from the Cis-Baikal Region of Eastern Siberia. Angela R. Lieverse. Affiliation: Department of Archaeology and Anthropology, University of Saskatchewan, Saskatoon, SK, S7N 5B1, Canada. Daniel H.
Temple. Affiliation: Department of Sociology and Anthropology, George Mason University, Fairfax, Virginia, United States of America. Vladimir I. Bazaliiskii.
1 Байкал. 9Варяг. 2Инстар. 24Интерскол. 200 Перфораторы. 5AEG. 1 BauMaster. 5Bosсh. 117 Плоскогубцы, клещи, кусачки. 12Рубанки ручные. Перфоратор « Байкал Е - 117А » изготавливается на Ижевском механическом заводе. Имеет довольно высокие технические и эксплуатационные. Скорость автозатемнения - 1/20 000 сек. www.mk-system.ru E -mail. Ручной пневматический перфоратор ПР-19 предназначен для бурения с руки или с. взрывозащищенные соответствуют ТУ 4371- 117 -12150638-2004 и.
Affiliation: Department of Archaeology and Ethnography, Irkutsk State University, Irkutsk, 664003, Russian Federation. Extensive osteolytic and osteoblastic lesions were observed on the skeletal remains of an adult male excavated from an Early Bronze Age cemetery dated to 4556+32 years BP, located in the Cis-Baikal region of Siberia (Russian Federation). Lytic lesions ranged in size from several mm to over 60 mm in diameter and had irregular, moth-eaten borders. Many of these lesions destroyed trabecular bone, though a hollowed shell of cortical bone often remained observable.
Radiographic analysis revealed numerous lytic lesions within trabecular bone that had not yet affected the cortex. Blastic lesions were identified as spiculated lines, bands, or nodules of mostly immature (woven) bone formed at irregular intervals. Anatomical elements with the greatest involvement included those of the axial skeleton (skull, vertebrae, sacrum, ribs, and sternum) as well as proximal appendicular elements (ossa coxae, proximal femora, clavicles, scapulae, and proximal humeri). Osteocoalescence of destructive foci was observed on the ilium and frontal bone, with the largest lesion found on the right ilium. Differential diagnoses include metastatic carcinoma, mycotic infections, tuberculosis, Langerhan's cell histiocytosis, and multiple myeloma. Based on lesion appearance and distribution, age and sex of the individual, as well as pathogen endemism, the most likely diagnostic option for this set of lesions is metastatic carcinoma.
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The age and sex of this individual and appearance of the lesions may reflect carcinoma of the lung or, possibly, prostate. This represents one of the earliest cases of metastatic carcinoma worldwide and the oldest case documented thus far from Northeast Asia. Citation: Lieverse AR, Temple DH, Bazaliiskii VI (2014) Paleopathological Description and Diagnosis of Metastatic Carcinoma in an Early Bronze Age (4588+34 Cal. BP) Forager from the Cis-Baikal Region of Eastern Siberia.
1 Байкал. 9Варяг. 2Инстар. 24Интерскол. 200 Перфораторы. 5AEG. 1 BauMaster. 5Bosсh. 117 Плоскогубцы, клещи, кусачки. 12Рубанки ручные.
PLoS ONE 9(12): e113919. doi:10. 1371/journal. pone. 0113919. Editor: David Caramelli, University of Florence, Italy. Received: July 10, 2014; Accepted: October 31, 2014; Published: December 3, 2014.
Copyright: © 2014 Lieverse et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License.
which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability: The authors confirm that all data underlying the findings are fully available without restriction. All relevant data are within the paper and its Supporting Information files. Funding: This research is part of the Baikal-Hokkaido Archaeology Project funded largely by the Social Sciences and Humanities Research Council of Canada (grant #412-2011-1001). Funding was also provided by the University of Saskatchewan and the University of North Carolina Wilmington. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: The authors have declared that no competing interests exist. Evidence for neoplasia in antiquity—and malignant neoplasia (cancer) in particular—is relatively scarce despite a growing number of reported cases published in the archaeological and paleopathological literature (e. [1] –[14] ). This, in contrast to the pervasiveness of the condition today, with cancer being the second leading cause of death in industrialized nations [15]. suggests that there remains tremendous gaps in knowledge regarding the history and evolution of neoplastic diseases [16] –[17]. Paleopathological investigation of neoplasia can, however, shed light on a range of these issues, including the distribution and variation of neoplastic diseases across time and space, as well as their relationships with changing demographic, genetic, and environmental factors [16].
[18]. Many scholars believe that neoplasia was substantially less common in the past than it is today, predominately reflecting shorter human life spans and more favorable environmental factors [15] –[17]. [19] –[22].
Others maintain that the prevalence of ancient malignancies, at least in the last several millennia, was not significantly different than that of modern industrialized societies [23]. This debate notwithstanding, it should come as no surprise that the number of archaeologically documented cases of neoplasia decreases relative to sample size and time depth: neoplasia frequency increases at sites that are relatively more recent and have larger sample sizes [16]. In fact, neoplastic diseases documented on human (or pre-human) skeletal material older than about 4000 years are remarkably rare, most reflecting “possible” neoplasia and/or benign conditions [7]. [24] –[30]. While malignant cancers—metastatic carcinoma and multiple myeloma, in particular—are among the most common types of neoplasia documented on archaeological remains [16]. [31] –[32].
the vast majority of these cases date within the last four millennia [2] –[4]. [6]. [8] –[13].
[33]. Here we present a case of malignant neoplasia from the Early Bronze Age (5200/5000–4000 cal. BP) hunter-gatherer cemetery of Gorodishche II, located in the Cis-Baikal region of Siberia. Extensive osteolytic and osteoblastic lesions located predominately on the axial and proximal elements of the appendicular skeleton indicate metastatic carcinoma, possibly of the lung or prostate. This represents one of the earliest cases of cancer metastasis among hunter-gatherers worldwide and the oldest case documented thus far from Northeast Asia.
Materials and Methods. This research is part of the Baikal-Hokkaido Archaeology Project (BHAP), housed at the University of Alberta, Canada. The BHAP and University of Alberta have an Agreement of Cooperation with Irkutsk State University (Russian Federation), where the skeletal remains described in this paper are curated. Permission is granted through this agreement (a copy of which was submitted to the PLOS editors for review) for BHAP researchers to access and study the hundreds of middle Holocene—Neolithic through Bronze Age—human remains housed at Irkutsk State University. The specimen discussed in this manuscript (Gorodishche II, Burial 3) was excavated by the third author, Vladimir Ivanovich Bazaliiskii of Irkutsk State University.
A copy of Bazaliiskii's excavation permit (#608) from the Russian Academy of Science's Archaeological Institute was also submitted to the editors review. All the human skeletal remains described in this study are curated by Irkutsk State University and were accessed with the permission of our Russian hosts and collaborators. Appropriate permits were obtained and regulations complied with. Gorodishche II is a small Early Bronze Age hunter-gatherer cemetery located in the Cis-Baikal, the vast mountainous region north and west of Lake Baikal in Southeastern Siberia, Russian Federation (Fig.
1 ). The cemetery is situated on the east bank of the Angara River, about 125 km north of the modern city of Irkutsk and 2.
5 km north of the much larger Late Neolithic-Early Bronze Age cemetery of Ust'-Ida I. Frequently, the terms ‘Neolithic’ and ‘Bronze Age’ imply sedentism, agriculture, and metallurgy.
However, in Siberian archaeology, Neolithic and Bronze Age economies are characterized by the introduction of pottery, ground stone, and bow and arrow technology, and by the appearance of (mostly decorative) copper and bronze, respectively [34] –[37]. Indeed, the Middle Holocene occupants of the Cis-Baikal were, in every sense of the word, mobile foragers subsisting predominately on game hunting, fishing, and sealing. doi:10. 1371/journal. pone.
0113919. g001. Three single interments were excavated from Gorodishche II in 1997, two dating to the Early Bronze Age (5200/5000–4000 cal. BP) and one to the more recent Middle-Late Bronze Age.
A fourth burial was completely destroyed. Burial 3, the subject of this paper, was one of the two Early Bronze Age burials recovered. Like the other interments at the site, it comprised a single individual placed in a pit and covered with a stone cairn. The burial pit was circular, measuring approximately 70 cm in diameter and 70 cm deep. The body was lying in a prone but tightly flexed position, with the knees drawn up to the chest (Fig.
2 ). Several remarkable grave goods were recovered with the body, including an ornamental bone tubule and an intricately carved bone spoon with a winding serpent handle (Fig. S1 ). The burial was directly radiocarbon dated to 4588–4524 years BP (OxA-26895: 4556±32 BP). doi:10. 1371/journal.
pone. 0113919.
g002. In 2012, a full osteological assessment of Burial 3 was completed by the first two authors. The skeleton was largely complete and well preserved, including the intact cranium and mandible, all major limb bones (long bones and those of the pectoral and pelvic girdles), most vertebrae and ribs, and about a third of the pedal and manual elements (Fig. 3 ). A conservative age at death estimate of 35–45 years was based on the morphology of the pubic symphysis and iliac auricular surface, as well as palatal and ectocranial suture closure [38] –[41].
Sex was determined as male based on cranial and pelvic morphology (as outlined by Buikstra and Ubelaker, [42] ). Some evidence of dental disease (periodontitis, calculus deposition, and antemortem tooth loss of the right maxillary first and second molars) was observed. However, the most apparent pathological changes involved extensive osteolytic and osteoblastic lesions distributed on most of the axial elements and the proximal appendicular bones (Fig. 3 ). In a number of cases, large portions of bones were missing altogether, likely the result of osteolytic destruction and/or taphonomic degradation subsequent to osteolysis. In addition to photographic, metric, and descriptive documentation of each lesion, radiographs were taken of the cranium, left ilium, right femur, and right humerus.
A diagrammatic representation and complete summary of all documented lesions are presented in Figure 3 and Table 1. respectively.
Expand Figure 3. Burial 3: Diagrammatic representation of skeletal completeness and lesion distribution; a, anterior view; b, posterior view. doi:10. 1371/journal.
pone. 0113919. g003.