The correct interpretation of pathology on skeletal remains is mandatory both for personal identification and at times for cause of death. However, because of the lack of skeletal collections with known pathologies, tools for interpreting pathology on dry bone are still missing. Prostate cancer is one of the most common tumors in old men, with a preference for the skeleton as primary site of metastasis, and therefore a possible frequent finding in skeletal remains. Its diagnosis on bone is however still ambiguous. This type of cancer has always been addressed as “osteoblastic”. Although recent data demonstrate that skeletal metastases have an extensive resorptive component, osteolytic lesions are rare findings. The present work intends to investigate and review the distribution and appearance of prostate cancer metastases on a series of known cases, in order to identify useful information for the diagnosis of metastases on dry bone. The study consists in the anthropological/pathological analysis conducted on 6 skeletons of subjects affected by prostate cancer in life (selected from the Milan Cemetery Skeletal Collection according to the known cause of death), and on 1 control case (healthy individual). A macroscopic inspection of each bone has been performed highlighting the abnormalities on each bone, and describing the location, shape, dimension, and aspect of both the cortical and spongy portion, all recorded on a specific form. Also episcopic and radiographic investigations have been conducted. The analysis showed that not in all cases prostate cancer involved the skeleton, although skeletal metastases were expected as related to the cause of death. Furthermore, while a great amount of proliferative lesions (more than 100) were observed in 4 cases, pure lytic lesions (more than 10) were displayed in the other 2 cases. The osteoblastic metastases were clear enough for a correct pathological diagnosis, but the osteolytic ones were more difficult to interpret, mostly for the easy confusion with other osteolytic tumors. Among all the lesions observed, a moderate percentage (25%, mainly proliferative) did not display features specific enough for assessing them as metastases. Such cases are precisely those that need deeper analyses for identifying the parameters necessary for recognizing them as prostate cancer metastases. In this perspective, supporting analyses, such as microscopy and radiology, provide a fundamental instrument in reducing the uncertainties.
The difficult task of diagnosing prostate cancer metastases on dry bone / E. Castoldi, D. Gibelli, A. Cappella, C. Sforza, C. Cattaneo. ((Intervento presentato al convegno IALM Symposium tenutosi a Venezia nel 2016.
|Titolo:||The difficult task of diagnosing prostate cancer metastases on dry bone|
CASTOLDI, ELISA (Primo)
GIBELLI, DANIELE MARIA (Secondo)
SFORZA, CHIARELLA (Penultimo)
CATTANEO, CRISTINA (Ultimo)
|Data di pubblicazione:||23-giu-2016|
|Parole Chiave:||forensic anthropology; bone metastases; prostate cancer; identification|
|Settore Scientifico Disciplinare:||Settore MED/43 - Medicina Legale|
Settore BIO/08 - Antropologia
|Citazione:||The difficult task of diagnosing prostate cancer metastases on dry bone / E. Castoldi, D. Gibelli, A. Cappella, C. Sforza, C. Cattaneo. ((Intervento presentato al convegno IALM Symposium tenutosi a Venezia nel 2016.|
|Appare nelle tipologie:||14 - Intervento a convegno non pubblicato|