Metastatic cancer in antiquity: Case study from 3rd-4th century Milan, Italy

Objective: To evaluate lesions noted on a 3rd-4th century individual and to contribute to our understanding of cancer in antiquity. Materials: Skeletal remains of a single individual recovered from the "Necropolis of the Cattolica", Milan, Italy. Methods: Macroscopic analysis, along with computed tomography and conventional radiography were employed to investigate lesions. Differential diagnosis was undertaken to assist with the diagnosis. Results: The individual was a male aged 40–65 years with extensive skeletal fragmentation. Osteoblastic lesions with thick new bone deposits and spiculae were present on the scapulae, vertebrae, and ossa coxae. Radiological analysis revealed increased radiodensity with a cloud-like matrix. Conclusions: Based on lesion distribution, morphology, and the individual's biological profile, metastatic carcinoma is suggested to be the most plausible diagnosis. Significance: This case contributes to the growing body of evidence for cancer in Roman Italy and highlights the role of paleo-oncological studies in reconstructing health patterns in past populations. Limitations: The fragmented nature of the skeleton limited the extent of lesion analysis. Further research: Expanding the dataset of ancient neoplastic cases will improve our understanding of cancer prevalence and evolution in past populations.