Strouhal E
Institute for the History of Medicine, Charles University, Prague, Czech Republic.
Anthropol Anz. 1993 Jun;51(2):97-115.
The paper deals with a case of a most probable metastatic carcinoma, found in skeletal remains of a 35-45 year old female who lived in Sayala, Egyptian Nubia, during the Christian Period. The macroscopic and radiographic morphology supported by microscopic investigation by M. Schultz (Göttingen) revealed the predominating osteoclastic process in the lesions, combining with the slightly expressed osteoblastic component. Single lesions located in the skull, spine, sacrum, sternum, ribs, clavicle, scapula, radius, metacarpals and hand phalanges, ossa coxae, femur and tibia were described. Of the various differential diagnostic possibilities, the diagnosis was focused on distinction between myeloma multiplex and lytic metastatic carcinoma. The growing evidence of incidence of metastatic carcinoma, its relative frequency compared with that of myeloma multiplex, and the most probable primary source of metastases of our case--the carcinoma of the breast--were discussed.
本文论述了一例极有可能为转移性癌的病例，该病例发现于一名生活在基督教时期埃及努比亚塞亚拉的35至45岁女性的骨骼遗骸中。由M. 舒尔茨（哥廷根）进行的显微镜检查所支持的宏观和放射学形态显示，病变中以破骨细胞过程为主，伴有轻度的成骨细胞成分。描述了位于颅骨、脊柱、骶骨、胸骨、肋骨、锁骨、肩胛骨、桡骨、掌骨和指骨、髋骨、股骨和胫骨的单个病变。在各种鉴别诊断可能性中，诊断重点在于区分多发性骨髓瘤和溶骨性转移性癌。文中讨论了转移性癌发病率不断增加的证据、其与多发性骨髓瘤相比的相对频率，以及我们病例中最可能的转移原发部位——乳腺癌。
