Objective

To undertake a differential diagnosis of a large mass found in the left maxillary sinus of a cranium dated to the 16th–17th-century, and to expand knowledge of the diagnosis of osseous tissue formation in osteoarchaeological studies.

Material

A cranium recovered from the cemetery of San Salvador de Palat de Rey church, León (Spain).

Methods

Macroscopic analysis, CT scanning.

Results

Macroscopic analysis indicated that the individual was probably a male over 30 years old with an ossified mass in the left maxillary sinus, measuring 24 × 19 × 24 mm, occupying approximately 27 % of the maxillary antrum. Computed tomography revealed a well-demarcated radiolucent unilocular mass with some radiopaque areas, with no communication with the alveoli of the premolars or molars. No erosive lesions or signs of inflammation were found.

Conclusions

Neither the macroscopic, nor the radiological characteristics are compatible with inflammatory or malignant pathology, favoring a diagnosis of ossifying fibroma.

Significance

This case adds to the few reported cases in the osteoarchaeological literature, especially since there is limited relevant reference data to assist diagnosis. The CT scans and 3D reconstruction presented here facilitate differential diagnosis in future paleopathological studies.

Limitations

Destructive methods were not authorized.

Suggestions for further research

In the future, micro-CT analysis, which was not performed in the current study, may add new and valuable information.

中文翻译：

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16-17 世纪西班牙成年男性上颌窦骨块：鉴别诊断。

 客观的

对在颅骨左侧上颌窦发现的可追溯至 16 至 17 世纪的大肿块进行鉴别诊断，并扩展骨考古学研究中骨组织形成诊断的知识。

 材料

从莱昂（西班牙）圣萨尔瓦多德帕拉德雷伊教堂墓地发现的头盖骨。

 方法

宏观分析，CT扫描。

 结果

宏观分析显示，该人可能为30岁以上男性，左侧上颌窦内有一骨化块，大小为24×19×24毫米，约占上颌窦的27%。计算机断层扫描显示边界清楚的可透射射线的单眼肿块，具有一些不透射线的区域，与前磨牙或磨牙的牙槽无连通。没有发现糜烂性病变或炎症迹象。

 结论

宏观特征和放射学特征均与炎症或恶性病理学不相容，有利于骨化纤维瘤的诊断。

 意义

该病例是骨考古文献中为数不多的报道病例的补充，特别是因为辅助诊断的相关参考数据有限。这里介绍的 CT 扫描和 3D 重建有助于未来古病理学研究中的鉴别诊断。

 局限性

破坏性方法未被授权。

进一步研究的建议

未来，当前研究中未进行的显微 CT 分析可能会添加新的有价值的信息。