A case of hemangioma of the skull vault in Medieval Italy: symptomatology, impact on lifestyle, and environmental factors

This study presents a case of calvarial hemangioma in an Early Medieval individual, exploring its potential effects on lifestyle and its historical context. The skeleton (Burial 2) is pertinent to the Early Medieval cemetery of Sesto Calende, Italy. The biological profile is reconstructed using standard anthropological protocols, and lesions are described following Ragsdale et al.’s (2018) terminology. The skeleton is estimated to be a male, with an age-at-death of 30–44 years. A sclerotic lesion on the parietal and frontal bone is observed: it shows bone expansion and cortical destruction of both the internal and external tables; the endocranial surface exhibits a “smooth shell” morphology with coarse trabecular matrix, while the ectocranial table is altered taphonomically. The differential diagnosis includes non-cancerous pathologies as well as malignant and benign neoplastic diseases, appearing consistent with a calvarial hemangioma. This benign vascular tumor is generally asymptomatic and unlikely to have affected daily activities. Nonetheless, in a medieval context, individuals with visible cranial anomalies may have been subjected to social stigma or superstition, potentially influencing their social interactions. This case contributes to our understanding of neoplastic conditions in ancient populations, offering insight into their biological expression, environmental and genetic determinants, and cultural perceptions of disease. The poor preservation of the skeleton limited the detailed analysis of the lesions, and broader comparative studies could further advance knowledge of neoplastic processes in ancient human remains.