Differential diagnosis of calcified nodules from a medieval Székely woman in Transylvania

Forensic imaging and analysis to assess soft tissue calcification in well-preserved human remains of a Székely woman from the medieval period was performed using XPERT 80-L from KUBTEC.

Objective: To differentially diagnose two calcified objects found with the well-preserved and nearly complete skeletal remains excavated in June 2012 by the Haáz Rezső Múzeum in Odorheiu Secuiesc, Romania.

Material: Two objects measuring 25.55 × 18.23 mm and 17.62 × 16.38 mm found with the skeletal remains of a probable female approximately 25-35 years old at the time of death.

Methods: Analysis utilized X-ray, SEM, EDS, CT scanning, and gross morphology to assess pathological conditions with calcification as a common sign.

Results: Multiple analyses of the objects revealed two roughened ovoid nodes with internal hollows and openings. Elemental analysis indicated an organic origin, likely representing calcified soft tissue.

Conclusions: Differential diagnosis determined the calcified nodules to be consistent with calcified tumors, and most consistent with a calcified leiomyoma with cystic degeneration, potentially uterine.

Significance: The identification of the calcified nodules as most consistent with calcified uterine leiomyomas adds to the paucity of paleopathological literature on calcified leiomyomas and calcified tumors more broadly. It also allows for an important discussion of the health of women in medieval Transylvania.

Limitations: Interpretation would be aided if a more precise origination within the body was known. Careful excavation and improved recognition of organic objects is necessary for a more definite diagnosis.

Suggestions for further research: soft tissue calcifications are a common process in a wide variety of diseases and can arise in all areas of the body. Pathological calcifications are relatively common in modern contexts but remain rare in paleopathological literature.

Heidi Miller, Jean Louise Lammie, Liotta Noche-Dowdy, Zsolt Nyárádi, Andre Gonciar, Jonathan D. Bethard


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