Meningiomas in Ancient Human Populations

SIMPLE SUMMARY: Meningiomas are the most common tumor of the central nervous system but are rare in the paleopathological record. Although they are technically a soft tissue phenomenon, they do leave various lesions on the skeletons, including thickened bone adjacent to the tumor and vascular impression changes. A review of the literature of health in past populations revealed some 43 cases of lesions identified by the original authors as meningioma. These cases are considered in terms of the appearance of the lesions as well as alternative diagnoses. The age distribution fits modern demographic patterns for meningioma patients but the sex distribution is roughly opposite of current patterns. It is suggested that meningiomas should be considered more often in differential diagnoses in ancient people. ABSTRACT: Meningiomas are the most common tumor of the central nervous system and can result in skeletal manifestations, including hyperostosis of the adjacent cranial bone, enostoses, depressions, and enhanced vascular impressions. However, their identification in the paleopathological literature has been rare and few cases have received broad acceptance of the diagnosis. A review of the literature identified some 43 cases in which individuals were argued to have suffered from meningiomas. Most were seen in older individuals but were more likely to affect males. Eleven individuals exhibited hyperostosis, the most easily recognized indicator, usually located on the parietal bone; the hyperostotic region averaged 8 cm in diameter and 3.0 cm in height. Seven displayed lytic lesions with areas much smaller in size than the hyperostosis, and many had vascular changes. The other cases had indicators that varied greatly in terms of location and expression and included both sclerotic lesions and hollow areas. Several authors also suggested other possible causes of the lesions. The findings reflect the non-pathognomonic nature of the effects of meningiomas. However, given their likely frequency and potentially severe effects in ancient people, it is argued that they should be taken into consideration more frequently when performing differential diagnoses.