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


Multiple Myeloma: How a Contemporary Forensic Anthropology Case Can Inform the Past

STEPHANIE PAULE1, BERTHA HURTADO-KOODRIN1, HEATHER WALSH-HANEY1 and MANFRED BORGES2.

1College of Arts and Sciences, Department of Justice Studies, Florida Gulf Coast University, 2District 20 Office of the Medical Examiner

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In collaboration with the District 20 Medical Examiner’s Office, Naples, Florida we present a forensic anthropology case of a destitute adult, European American male exhibiting prolific lytic activity consistent with multiple myeloma. Our review of the osteological literature highlighted a dearth of contemporary cases of clinically confirmed multiple myeloma that lacked modern medical intervention. As such, this contemporary case provides data to help the differential diagnoses of ancient skeletal remains that exhibit the condition and becomes one of a few comparative standards that help biological anthropologists identify the condition. Furthermore, we present the myriad conditions eliminated via differential diagnosis.

Multiple myeloma, metastatic carcinoma, Langerhans cell histiocytosis, and mycotic infection exhibit overlaps in the distribution and morphology of the lytic lesions that identify these skeletal pathologies. However, we identified the skeletal pathology as multiple myeloma via macroscopic examination and radiographs which revealed bilateral osteolytic bone resorption that exhibited a ‘punched-out’ appearance and lack of osteoblastic activity. We validated our diagnosis by means of examination of the decedent’s medical records and laboratory results. Specifically, the medical records revealed a clinical diagnosis of multiple myeloma affirming hypercalcemia, hyperproteinemia, elevated IgG levels, low IgA and IgM levels, and anemia of chronic disease.

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