Large lytic cranial lesions: A differential diagnosis from pre-Angkorian Cambodia
Article first published online: 29 DEC 2010
Copyright © 2010 John Wiley & Sons, Ltd.
International Journal of Osteoarchaeology
Volume 22, Issue 6, pages 731–739, November/December 2012
How to Cite
Domett, K.M. and Buckley, H.R. (2012), Large lytic cranial lesions: A differential diagnosis from pre-Angkorian Cambodia. Int. J. Osteoarchaeol., 22: 731–739. doi: 10.1002/oa.1234
- Issue published online: 12 DEC 2012
- Article first published online: 29 DEC 2010
- Manuscript Accepted: 5 NOV 2010
- Manuscript Revised: 31 OCT 2010
- Manuscript Received: 10 NOV 2009
- Langerhans' cell histiocytosis;
- lytic lesions;
- metastatic carcinoma
A late pre-Angkorian period, c. 350 BC - 200 AD, cemetery has been excavated in the village of Phum Snay, in northwestern Cambodia. In addition to the cemetery sample, a large sample of stratigraphically unprovenanced human skeletal material was uncovered in the village through extensive looting over the last 5–10 years. Both sample sets were available for study but the latter is comprised of only isolated bone elements. The differential diagnosis of the cause of lesions in one isolated cranial vault from this sample is presented here. Widespread, primarily lytic, lesions are concentrated on the frontal and anterior parietal bones, with an additional large lesion on the occipital bone. Lesions vary in size ranging from approximately 5–30 mm in diameter. A detailed description of these lesions is given and a differential diagnosis is presented that includes infectious disease, such as osteomyelitis, tuberculosis and treponemal disease, and also several forms of cancer including metastatic carcinoma, meningioma and multiple myeloma, and finally Langerhans Cell Histiocytosis. The diagnosis is difficult, given the lack of material, but it is suggested that one of the forms of Langerhans Cell Histiocytosis is the most likely candidate. The presence of such large and diffuse lesions is unusual in prehistoric Southeast Asia so the significance of this is also discussed. Copyright © 2010 John Wiley & Sons, Ltd.