A probable case of multiple myeloma from Bronze Age China.

Abstract Objective Paleopathological evidence of cancer from past populations is rare, especially outside of Europe and North Africa. This study expands upon the current temporal and spatial distribution of cancer by presenting a probable case of multiple myeloma from Bronze Age China. Material The human skeletal remains of an adult male from the Qijia culture horizon (1750−1400 BCE) of the Bronze Age cemetery of Mogou (磨沟), located in Gansu Province, Northwest China. Methods The human skeletal remains were assessed macroscopically and radiographically using plain x-rays. Results Multiple ovoid-shaped osteolytic lesions with sharply demarcated margins were observed. The axial skeletal had the greatest involvement, specifically the vertebrae, ribs, and sternum. Radiographic imaging revealed more extensive destruction of cancellous than cortical bone, indicating that the marrow was the focal point of the disease. Conclusion Based on the nature, distribution, and radiographic appearance of the lesions, the most likely diagnosis is multiple myeloma. Significance This is one of the only cases of cancer identified in archaeological human skeletal remains from East Asia and is the first published case of a hematopoietic malignancy from mainland China. The analysis and publication of examples of neoplasia from areas that expand upon the current known temporal and spatial distribution is necessary in order to better reconstruct the history and evolution of cancer. Limitations Poor skeletal preservation prevented the full extent of osteolytic lesions to be observed. Suggestions for future research By placing case studies such as this into a temporal and spatial framework, it is possible for future research to begin to interrogate possible underlying causes of cancer in ancient populations within the context of changing environmental conditions and subsistence strategies.