In a recently accepted article to be published in the International Journal of Paleopathology, Nicole Smith-Guzmán of the Smithsonian Tropical Research Institute and her colleagues report their diagnosis of a bone tumor in the upper arm of a person between 14 and 16 years old at death. The skeleton comes from the site of Cerro Brujo, on the Aguacate Peninsula in the province of Bocas del Toro in western Panama. With two occupation periods, Cerro Brujo was inhabited between about 600-1250 AD, its residents participating in a mixed economy that involved fishing, farming, and hunting. There were only two burials at the site, and based on radiocarbon dates, this person was buried long after the settlement was abandoned.
The adolescent in question was actually interred in the largest of five ancient trash pits. The teen had been tightly wrapped after death and placed face-down in the pit. The skeleton was incomplete, with several bones missing. But enough remained for Smith-Guzmán and her team to find a number of pathologies. Teeth were pitted from an unknown childhood disease, with cavities and plaque. The skull was also pitted and porous, revealing an anemic condition. And the lower legs had extra bone growth signifying the skeleton's response to an unidentified injury or disease. The authors write that "the severe lesions of anemia and inflammation visible in other areas of the skeleton suggest that this individual was afflicted by some type of physiological stressor for some time."
But the most dramatic pathology the team found was in the right upper arm. The mid-shaft of the humerus had a large mass of bone that did not fit the profile of a poorly-healed fracture. Rather, the mass more clearly lines up with a diagnosis of either osteosarcoma or Ewing sarcoma, both known today as the most common malignant bone tumor in children. And this condition would not have been pleasant. Smith-Guzmán and colleagues note that the teen's arm would have appeared swollen in life and that, "based on clinical observations of patients with primary bone tumors," this person "would likely have experienced intermittent pain in the right arm as the tumor slowly grew and expanded."
Given cultural records from this region, the authors speculate that this teenager likely would have been treated by a shaman, or an intermediary between the worlds of the living and the dead. Remedies may have included herbal poultices made from plants with pain-relieving properties. "Whatever the medical treatment," Smith-Guzmán and colleagues explain, "this individual did not overcome the illness and died about 1300 AD shortly after reaching puberty."
When the teenager was buried, the settlement of Cerro Brujo had been abandoned, so the placement of the grave there is somewhat odd. It may reflect ancestral ties to the site, the authors think, and may be a burial of ritual significance. They base this conclusion on the fact that the teenager was not carelessly thrown into the trash pit. Rather, there were two whole pottery vessels and a shell trumpet buried with the person. And the special form of burial - flexed in a fetal position rather than extended in a lying-down position - also speaks to the potential importance of the teenager.
"Rather than being cast out of society as a cursed individual or discarded carelessly in the trash as a diseased individual," Smith-Guzmán and colleagues conclude, "this young person seems to have been buried with care alongside ritually significant items at a site connected with their ancestors."
As primary bone cancers are unusual in ancient skeletal remains, the authors encourage other researchers to publish their own potential cases of cancer, and they provide 3D models of the humerus of this Panamanian teenager for access through SketchFab.
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