Identification and study of carcinoma in 



paleopathological material: 



Present status and 



future directions 



James M. Tenney 



ooft tissue has not received the extensive study that bone has 

 in paleopathology owing largely to the limited availability of 

 material and the more destructive nature of the techniques 

 involved. The discussion centers about past effort in soft 

 tissue paleopathology with respect to carcinoma, and its rela- 

 tion to present and future studies, problems, limitations, and 

 potential value. Carcinomas of prostate, colon, and breast 

 are taken as prototypes representing common present-day 

 tumors. 



Carcinoma is defined as a malignant neoplasm arising 

 from an epithelial surface, be it skin, the lining of an organ 

 (colon, bronchus of lung), the epithelium-lined ducts of an 

 organ (breast, liver), or small epithelial glandular structures 

 present in the organ itself (prostate, pancreas). Though the 

 term "soft tissue tumor" is used somewhat differently in pa- 

 leopathology, its general usage in pathology refers to any 

 neoplasm arising from mesenchymal tissue other than bone, 

 bone marrow, cartilage, or lymph nodes, and excluding car- 

 cinoma (Stout and Lattes 1967: 15). 



In the older medical literature and that of ancient times, the 

 word "tumor" referred to any swelling, whether it was infec- 

 tious (boil or abscess), traumatic ("goose-egg"), or neoplas- 

 tic (benign or malignant). The large abdomen in a gestational 

 woman was even referred to as the "ovoid tumor of pregnan- 

 cy." Current usage restricts the meaning to neoplasia, benign 

 or malignant. This would exclude many lesions classified as 

 tumors in the paleopathology literature (auditory osteomas, 

 "collar-button" osteomas, congenital and traumatic epider- 

 moid cysts, tori, myositis ossificans, osteochondromas, 

 etc.). An acceptable alternative would be to refer to these as 

 "tumor-like conditions" (Aegerter and Kirkpatrick 1968: 

 546). 



Zagreb Paleopathology Symp. I98S 



Past 



In the past there has been a fair amount of descriptive litera- 

 ture regarding cancer in ancients, mostly in bone. Some was 

 carefully documented and described, with cautious conclu- 

 sions as to general diagnosis of cancer and sometimes even a 

 specific diagnosis (for example, osteogenic sarcoma). A well 

 thought-out differential diagnosis was included. In other 

 cases, however, a hodgepodge of fanciful guess work with 

 little scientific basis was submitted with no mention of other 

 diagnostic possibilities. Both kinds become equals in the 

 literature and get incorporated into tables and statistics of 

 later papers, becoming translated as fact. There have been 

 few attempts to restrain excessively speculative diagnoses. 



Only a handful of nonosseous tumors have been described, 

 and even fewer with microscopic findings (Zimmerman 

 1981 :364). A recent survey summarizes bone and soft tissue 

 tumors in Egypt and Nubia (Pahl 1986). 



Uniformity of diagnosis presents a recurring problem. 

 This lack is not surprising, as there are more problems than 

 answers in paleopathology. It is always tempting to classify 

 things, and some of the problems might be placed in the 

 following manner: 



1 . Problems inherent in the archeological site 



a. provenience 



b. is theburial representative of the group at that site? 



c. is the group at that site representative of the popula- 

 tion as a whole at that time and at that place? 



2. Problems with the specimen itself 



a. incomplete material (bones and/or soft tissue missing 

 or partially missing) 



b. poor condition or preservation of the specimen 



261 



