The 82nd Annual Meeting of the American Association of Physical Anthropologists (2013)


Histopathology and Differential Diagnosis of a Pelvic Calcification

MURRAY K. MARKS1 and MICHELLE D. HAMILTON2.

1Pathology, University of Tennessee Health Science Center, 2Anthropology, Texas State University

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Due to rarity and poor preservation, the discovery of extra-osseous neoplastic inclusions with prehistoric, historic or modern skeletal remains has received limited attention. Komar and Buikstra (2003) developed a differential diagnostic approach in their examination of a prehistoric pelvic calcification and this presentation offers a similar opportunity to histologically examine and diagnose a modern pelvic neoplasm.

A spherical, calcified tissue shell was recovered within the pelvic inlet of a decomposing 65 year old White female allowing diagnosis as an obstetric or gynecological neoplasm. Malignant and benign growths include ovarian sarcrcoma, fibroma, cyst or lymphoma; uterine leiomyoma, leiomyosarcoma, Brenner’s tumor or abnormal fetal neurocranial bone.

Light microscopy at 10x, 20x and 60x was utilized to differentially diagnose demineralized and non-demineralized sections of the calcification. The degree and quality of calcification and the cellular appearance of the cortex provided the main differential diagnostic features. Uterine leiomyomas, ovarian fibromas, Brenner’s tumors frequently calcify and of course, cranial bone mineralizes. However, sarcomas, cysts and lymphomas rarely undergo calcification and have different cellular structure. Histologically, spindle cells and abundant cartilage are pathogonomic for fibromas and this specimen is characterized by these features. An absence of smooth muscle cells rules out the uterine leiomyomas. Besides clinical anecdotal interest, this case serves as an exemplar for extra-osseous inclusions associated with the pelves of prehistoric, historic or forensic skeletons.

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