Calcified uterine leiomyoma from an 18th-century nunnery in North Italy

Abstract

Objective: To develop a differential diagnosis of a mass retrieved alongside skeletal remains in the crypt of the church of Santissima Annunziata of Valenza (Province of Alessandria, Northern Italy).

Material: A calcified mass measuring 40 × 39 mm and 17.62 × 16.3817.62 × 16.38 mm.

Method: The analysis utilized macroscopic assessment and histologic examination (including histochemical and immunohistochemical analyses).

Results: Morphological traits include an irregular and spongy external surface. Holes of different sizes lead toward the inner part of the object. A section of the mass shows an "intertwined bundle" pattern, confirmed by microscopic examination.

Conclusions: Differential diagnosis determined the mass to be consistent with calcified leiomyoma.

Significance: Identifying uterine leiomyoma adds to the paucity of paleopathological literature on the condition and to calcified tumors more broadly. It also allows for an important discussion of women's gynecological health in the past and potentially among nulliparous women.

Limitations: Neither histochemical staining nor immunohistochemical analysis demonstrated the certain muscular nature of the specimens due to the rehydration and decalcification processes, for which there are no gold standards.

Suggestions for further research: Calcified masses are common in the clinical literature but remain rare in paleopathological literature. Careful excavation and improved recognition of apparently calcified masses are necessary to improve recognition, diagnosis, and interpretation.

Keywords: Calcification; Calcified tumor; Myoma; Soft tissue tumor.