Osseous mass in a maxillary sinus of an adult male from the 16th-17th-century Spain: Differential diagnosis

Abstract

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, Leon ´ (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.