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一具史前安第斯肩胛骨肩胛盂切迹处的圆形凹陷:肩胛上神经被盂唇旁囊肿卡压的可能证据。

A circular depression at the spinoglenoid notch of a prehistoric Andean scapula: Plausible evidence of suprascapular nerve entrapment by a paralabral cyst.

作者信息

Titelbaum Anne R, Ibarra Asencios Bebel, McNeil Bronwyn E

机构信息

Basic Medical Sciences, University of Arizona College of Medicine - Phoenix, Phoenix, AZ, 85004, USA.

Department of Anthropology, Tulane University, New Orleans, LA, 70118, USA.

出版信息

Int J Paleopathol. 2019 Mar;24:19-24. doi: 10.1016/j.ijpp.2018.08.007. Epub 2018 Sep 20.

Abstract

While intraosseous cysts have been described in the paleopathological literature, it is rare to find reports concerning effects of soft tissue cysts, although they are relatively common in clinical contexts. Here we present plausible evidence of an extraosseous paralabral cyst, seen in an adult scapula from a Late Intermediate period commingled tomb (ca. AD 1200) at the northern highland site of Marcajirca, Ancash, Peru. The scapula demonstrated a smooth-sided concave depression at the spinoglenoid notch. The depression was notable for its regular appearance, with no bone deposition or destruction. Rather than reflect an intraosseous pathology, the defect likely resulted from pressure erosion from a space-occupying mass. A narrow strip of flattened bone connected the depression to the posterior-superior aspect of the glenoid. The location and morphology of the depression and its connection with the glenoid are consistent with the effects of a paralabral cyst that arose secondary to a tear of the posterior-superior glenoid labrum. A labral tear may act as a one-way valve permitting fluid to flow along a path of least resistance, often to the spinoglenoid notch. A cyst at the spinoglenoid notch would compress the suprascapular nerve, causing weakened function of infraspinatus and its eventual atrophy.

摘要

虽然骨内囊肿在古病理学文献中已有描述,但关于软组织囊肿影响的报告却很少见,尽管它们在临床情况下相对常见。在此,我们展示了一个骨外盂唇旁囊肿的合理证据,该囊肿见于秘鲁安卡什马尔卡希尔卡北部高地遗址一个晚期中期混合墓葬(约公元1200年)出土的一具成人肩胛骨。肩胛骨的肩胛冈盂切迹处有一个边缘光滑的凹陷。该凹陷的外观规则,无骨质沉积或破坏,颇为引人注目。该缺损并非反映骨内病变,而可能是由占位性肿块的压力侵蚀所致。一条狭窄的扁平骨带将凹陷与关节盂的后上缘相连。凹陷的位置和形态及其与关节盂的连接情况与盂唇旁囊肿继发于关节盂后上唇撕裂的影响相符。盂唇撕裂可能起到单向阀的作用,使液体沿阻力最小的路径流动,通常流向肩胛冈盂切迹。肩胛冈盂切迹处的囊肿会压迫肩胛上神经,导致冈下肌功能减弱并最终萎缩。

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