A probable case of holoprosencephaly with cyclopia in a full-term fetus from a modern skeletal collection

Insights into the anatomical expressions of anencephaly in three infants from 17th to 19th- century Lisbon, Portugal

OBJECTIVE

This study aims to analyse and compare the cranial morphological variations in three individuals, each exhibiting different severity levels of malformations.

MATERIALS

Three nearly complete and well-preserved skeletons of infants from the São Domingos children's necropolis in Lisbon, Portugal, dating from the 17th to early 19th centuries.

METHODS

Macroscopic and metric assessments were performed aimed at creating a detailed description of the skeletons.

RESULTS

The three infants exhibit an absence of the upper cranial vault, accompanied by several cranial bone alterations such as abnormal development and morphology of the occipital, sphenoid, temporal, and frontal bones. Additionally, two of the infants present maxillary and dental anomalies.

CONCLUSIONS

The three infants from the São Domingos necropolis provide crucial insights into the presence of anencephaly in an historical population, representing an exceptionally rare archaeological find. The distinct cranial abnormalities strongly support the diagnosis and highlight varying severity levels of the condition.

SIGNIFICANCE

These examples enhance the recognition of anencephaly in archaeological contexts and deepen the understanding of its varied bone expressions. Examining skeletal variations within the same condition also complements the broader palaeopathological discussion of rare diseases.

LIMITATIONS

The lack of soft tissue preservation reduces a comprehensive assessment of anencephaly in skeletal remains. The archaeological context presents challenges such as fragmentation. Additionally, determining postnatal survival is difficult due to the subtle or absent skeletal indicators that might suggest survival beyond birth.

SUGGESTIONS FOR FURTHER RESEARCH

Biomolecular genetics analysis could be a valuable approach for future research.

Ecce Homo: Moving past labels to lives

OBJECTIVES

We report a contemporary individual who died with advanced holoprosencephaly (HPE) to encourage recognition of rare diseases (RDs), especially congenital conditions in archaeological samples. We also explore the range of conditions associated with hydrocephalus in support of nuanced interpretations of this disease.

MATERIALS

The skeleton of a 17-year-old male who died with clinically diagnosed HPE, along with an age and sex matched comparative sample of 6 individuals who suffered accidental death and who were normal.

METHODS

We observed and measured all remains using standard osteological methods. The clinical records for Ecce Homo were scrutinized; his family was interviewed, and his skull was X-rayed.

RESULTS

The morphology and morphometry of Ecce Homo's skeleton display irregularities along the cranial midline and the postcranial skeleton consistent with anomalies derived from HPE as well as related congenital disorders and physical anomalies.

CONCLUSIONS

We have reported HPE here and developed a differential diagnosis with closely related conditions. Likewise we relate the information generated in the clinical history and interviews with the family of Ecce Homo to facilitate an understanding of the social context.

SIGNIFICANCE

This case is exceptional in providing information from the life context of a contemporary individual who suffered from a rare disease (HPE), with skeletal remains could be studied extensively. The differential diagnosis is useful in identifying HPE and other closely related conditions.

LIMITATIONS

This is a single example with clinical intervention.

SUGGESTIONS FOR FURTHER RESEARCH

Future osteological research should occur on other cases of HPE; molecular studies may offer further clarity.

Cyclopia baby: Congenital lethal malformation: Rare case report

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Cyclopia is a rare congenital disorder with life-threatening complications.

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Early diagnosis during pregnancy should be emphasized to prevent its complications.

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Early diagnosis is important to allow for early termination of pregnancy and to minimize the physiological and psychological impact of such anomalies on the mother and family.

Cyclopia, a newborn with a single eye, a rare but lethal congenital anomaly: A case report

Introduction and importance

Cyclopia is a rare congenital disorder characterized by facial abnormalities. In this condition, the orbits of the eye are not properly divided into two cavities so that they can be seen either as a single eye field or two bilateral fields that are very close to each other. This syndrome affects the embryos that are either aborted or stillborn upon delivery or, at best, die shortly after birth.

Case presentation

This case report is of a 37-week- and 5-day-old female fetus with a birth weight of 2300 g, a height of 43 cm, and a head circumference of 31 cm. She was born to a 44-year-old mother through normal vaginal delivery at Mahzad Hospital, Urmia, Iran. In the physical examination, an eye and a 4-cm proboscis were seen in the middle of the forehead. The newborn also had no nose, and his outer ears were normal. No cleft lip or cleft palate was observed. Unfortunately, the newborn expired 13 h after birth.

Clinical discussion

Cyclopia leads to a stillbirth since the brain and other parts of the body do not grow normally in fetuses with this disorder. Moreover, it can be diagnosed using ultrasonography while the fetus is growing inside the uterus.

Conclusion

Early diagnosis during pregnancy using diagnostic methods and proper management of this abnormality should be emphasized to prevent further harm to the newborn and the mother with this syndrome. Moreover, many of these newborns should be offered early neonatal palliative care.

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Cyclopia is a rare congenital disorder with life-threatening complications.

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Cyclopia mostly affects the embryos that are either aborted or stillborn.

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Early diagnosis during pregnancy should be emphasized to prevent its complications.

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Prenatal palliative care emphasizes the importance of planning for the experience of losing an infant.

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Parental involvement in end-of-life care for their infant is an important aspect of neonatal palliative care.

The Importance of Historical Medical Records Review in the Interpretation of Dry Bone Lesions on Identified Skeletal Remains: A Case Study of a Polymorbid Male (1895-1940)

ABSTRACT

The examination of documented skeletal remains provides an exceptional opportunity for biohistorical research to answer questions about an individual's life and death. Research in this area also makes it possible to assess the reliability of historical records from the period of interest, which is often the subject of discussion, especially in cases of historically known individuals. The remains of K.B.C. (1895-1940), a prominent local landowner and politician, were exhumed because of the repair of a family tomb in Jíloviště, Czech Republic. The aim of this study was to analyze pathological changes in his bones and to interpret these by comparing them with the results of a historical medical records review of private family and public archives regarding his diseases and death, thus verifying their credibility. Morphological and X-ray examinations of the bones revealed several serious pathological changes, whose presence fully corresponded to the studied documents. This showed the records' reliability, and it was thus possible to accurately interpret the lesions found. The results demonstrated the need for interdisciplinary collaboration in the analysis of such cases, including the assistance of the living descendants of the studied individuals, if possible.