International Journal of Osteoarchaeology Int. J. Osteoarchaeol. 18: 492–506 (2008) Published online 14 November 2007 in Wiley InterScience (www.interscience.wiley.com) DOI: 10.1002/oa.950
A Case of Multiple Metastasis in Late Holocene Hunter-Gatherers from the Argentine Pampean Region L. H. LUNA,a* C. M. ARANDA,b L. A. BOSIO c AND M. A. BERON d a
CONICET, Museo Etnogra´fico J. B. Ambrosetti, Facultad de Filosofı´a y Letras, Universidad de Buenos Aires, Moreno 350 (1091), Ciudad Auto´noma de Buenos Aires, Argentina b Museo Etnogra´fico J. B. Ambrosetti, Facultad de Filosofı´a y Letras, Universidad de Buenos Aires, Ciudad Auto´noma de Buenos Aires, Argentina c Servicio de Antropologı´a Forense, Ca´tedra de Medicina Legal, Facultad de Medicina, Universidad de Buenos Aires, Ciudad Auto´noma de Buenos Aires, Argentina d CONICET, Museo Etnogra´fico J. B. Ambrosetti, Facultad de Filosofı´a y Letras, Universidad de Buenos Aires. INCUAPA, Facultad de Ciencias Sociales, Universidad del Centro de la Provincia de Buenos Aires, Argentina
ABSTRACT
Chenque I site is a prehistoric cemetery located in Lihue´ Calel National Park (La Pampa province) in the Western Pampean region of Argentina. Hunter-gatherer societies made use of this site during the Final Late Holocene for at least 700 years (1030–370 BP). Currently 41 burial structures have been excavated, and more than 150 individuals have been recovered. There is great variability in mortuary patterns at the site (simple, multiple, primary, secondary burials, and also a variant not previously observed in the region). The life-ways of this population have been investigated through the evaluation of several biological and cultural factors. Several pathological conditions have also been identified in this cemetery. Burial no. 12 contains a skeleton of an adult male that shows multiple pathological lesions, compatible with a neoplastic disease. These lesions have been analysed using several methodological strategies: macroscopic, radiological and microscopic. This is the first time that this kind of disease has been identified from a prehistoric burial in Argentina. In this paper the location and characteristics of the lesions are evaluated, and the different neoplastic diseases that could have produced them are discussed. Since the people buried in this cemetery belonged to highly mobile societies, a key issue is to infer the consequences that this disease would have had on the dynamics of the group in which this person lived, because of the gradual deterioration of his health and physical strength. Copyright ß 2007 John Wiley & Sons, Ltd. Key words: bioarchaeology; palaeopathology; multiple metastasis; cancer; huntergatherers; Pampean region; Argentina
.
Introduction This paper describes and interprets lesions identified in the bones recovered from Burial no. 12 * Correspondence to: CONICET, Museo Etnogra´fico J. B. Ambrosetti, Facultad de Filosofı´a y Letras, Universidad de Buenos Aires, Moreno 350 (1091), Ciudad Auto´noma de Buenos Aires, Argentina. e-mails: luna@mail.retina.ar; lunaranda@gmail.com
Copyright # 2007 John Wiley & Sons, Ltd.
from the Chenque I site. This site is a prehistoric cemetery located in Lihue´ Calel National Park (La Pampa province), in the western Pampean region, Argentina (Figure 1). The results obtained are discussed, with an attempt to identify the type of disease that could have caused these lesions, the symptomatology suffered by this individual, and the potential biosocial consequences. Received 15 March 2006 Revised 20 April 2007 Accepted 25 April 2007
A Case of Metastasis in Hunter-Gatherers from Argentina
493
Figure 1. Location of the Lihue´ Calel National Park, and the Chenque I site. This figure is available in colour online at www.interscience.wiley.com/journal/oa.
Hunter-gatherer societies made use of the Chenque I site during the end of the Late Holocene, between 1030 and 370 BP. This chronological range was obtained from nine radiocarbon dates (Table 1). So far, 49 square metres have been excavated, about 23% of the total area. This cemetery has two units clearly defined, each with very different characteristics. The Superior Unit (0–30 cm depth) contains thousands of bony and dental remains of different degrees of fragmentation, commingling, arrangement and anatomic association. These characteristics are the consequence of the intensive reutilisation of the Copyright # 2007 John Wiley & Sons, Ltd.
cemetery over 700 years. In the Inferior Unit (below 30 cm), 41 burials were found. Most of these burials are clearly defined because of two circumstances: the presence of stone structures above or under the corpses, and/or the lack of archaeological items around them. We have recorded a great deal of variability of inhumations at this site: simple, multiple, primary, secondary burials, as well as a variant not previously registered in the country, called disposition. This term refers to a situation in which the anatomical structure of the corpse is modified immediately after death, with an intentional arrangement. It Int. J. Osteoarchaeol. 18: 492–506 (2008) DOI: 10.1002/oa
L. H. Luna et al.
494 Table 1. Radiocarbon dates from the Chenque I site Sample origin
Lab source
Radiocarbon date (BP)
Superior Unit
AA 35950 AA 35951 UGA 10627 UGA 10628 AA 35952 AA 35953 UGA 10624 UGA 10625 UGA 10626
1029 43 869 43 740 70 730 70 904 43 901 43 700 40 830 40 370 40
Burial Burial Burial Burial Burial
7 8 14 15 16
Material Third upper left molar Third upper left molar First upper left molar Second lower left premolar Third upper left molar Third upper right molar Lateral upper left incisor Proximal foot phalange Proximal hand phalange
Source: Adapted from Bero´n and Baffi (2004: 392).
occurs prior to the skeletonisation process, when soft tissues are still present. Different skeletal parts of the body (skull, trunk, apendicular skeleton, etc.) were disarticulated and reordered, forming a funerary package with definite limits (Bero´n et al., 2000, 2005; Bero´n, 2004; Luna et al., 2004). Due to the multiple forms of evidence and the great quantity of recovered information, Chenque I site is one of the most important hunter-gatherer mortuary sites in Argentina. In both units, a great deal of cultural material has been identified. The majority of the artefacts are beads manufactured from different raw materials (mollusks, bone, stone, etc.), but other ornaments have been also found (e.g. metal pendants). The MNI (minimum number of individuals) identified so far for the Superior Unit is 53, and for the Inferior Unit 105, for a total of 158 individuals, including adults and subadults, males and females. The methodological procedures employed to obtain the MNI value are described in Bo¨ko¨nyi (1970), Orchard (2005) and Ubelaker (1974). It can then be stated that at this site several hundred bodies have been buried, which is a significant point because the societies that buried the corpses here were hunter-gatherer groups with a high degree of mobility, long-distance exchange and interaction networks (Bero´n et al., 2000, 2002, 2005; Bero´n, 2003, 2004, 2005a,b; Luna, 2003; Luna et al., 2004; Bero´n & Luna, 2005a,b).
Osteological analysis Burial no. 12 contains a skeleton of an adult male approximately 40–50 years old, buried in a Copyright # 2007 John Wiley & Sons, Ltd.
primary flexed position (Figure 2). Estimation of sex was obtained through the metrical evaluation of the humeral and femoral heads and the morphological analysis of the fragments of the os coxae (Bass, 1987; Buikstra & Ubelaker, 1994). Age-at-death was estimated by evaluating the characteristics of the pubic symphysis (Todd, 1921a,b; Katz & Suchey, 1986). This man’s stature in life is estimated at 185 9 cm. This burial is located in the outermost southwest end of the site, and only two valve beads were associated with the bones. Direct radiocarbon dating was not possible because of the lack of bone collagen, but this burial is included in the chronological range of the site, as mentioned above. The skeleton shows numerous pathological lesions at a number of sites. The bones recovered, shown in Figure 3, were analysed macroscopically, radiographically and microscopically. The skeleton is incomplete (about 70% of the bones were recovered), with a number of missing bones: the skull, teeth (except the first right lower premolar), sternum, left scapula, clavicle, radius and ulna; right humerus, patella and tibia, and almost all the bones of both hands. These bones could be absent because of the action of multiple taphonomic agents (Di Donato, 2005). In the specific case of the skull, its absence may also be related to a particular mortuary behaviour. In fact, three cases of isolated skulls have been found at the site (Bero´n & Luna, 2005b). The burial of isolated anatomical parts has also been recorded at other sites in the Pampean Region (Mazzia et al., 2004). The elements that present the lesions described below have a high degree of fragmentation. The majority of the lesions, when viewed macroscopically, are numerous, well-defined Int. J. Osteoarchaeol. 18: 492–506 (2008) DOI: 10.1002/oa
A Case of Metastasis in Hunter-Gatherers from Argentina
495
Figure 2. Burial 12. Note the primary modality and the absence of several bones (i.e. the skull).
osteolytic images, located only in specific areas of the skeleton: the thorax (dorsal arches of vertebrae and diaphyses of ribs) (see Figure 4), the pelvis (os coxae and sacrum) and scapula (body and coracoid process) (Figure 5), and proximal epiphyses of both femora, left humerus (Figure 6) and right ulna. The long bone diaphyses, their distal epiphyses, and the bones of feet are unaffected. The shape of the lesions is rounded/elliptical, in several cases irregularly shaped, or geographical (Rothschild et al., 2002), confluent, with blunt borders. In all the cases, the maximum diameter does not exceed 8 mm. X-ray images were taken of the pathological bones. They show similar images, that is, several osteoclastic lesions with well-defined limits and without sclerotic borders. They are clearly identified in the vertebrae (Figure 7), the right scapula (Figure 8), and the proximal third of the femora (Figure 9). Many small circular and ovoid lesions, several medium to small oval foci, and Copyright # 2007 John Wiley & Sons, Ltd.
some large pseudocircular areas of lucidity were identified radiographically in all the bones that were externally affected. Practically all the inner foci penetrate the outer lamina, so there are external manifestations in the form of roughly circular and oval foci of different dimensions in the cortical bone in all cases. Some of the bones were observed in a scanning electron microscope (SEM). The images are similar to the macroscopic observations. The trabeculae of the spongy bone show multiple destructive cavities, which are Howship’s lacunae, irregularly-located products of osteoclastic activity. The borders of the osteolytic images are smooth, without new bone formation (Figures 10 and 11). Some images show earlier steps in the destructive process (Figure 10), while others show the latest manifestation of osteoclastic activity (bottom of Figure 11). Moreover, several osseous exostoses were identified in different zones of the skeleton. For Int. J. Osteoarchaeol. 18: 492–506 (2008) DOI: 10.1002/oa
L. H. Luna et al.
496
Figure 5. Coracoid process of the right scapula with several osteoclastic lesions. This figure is available in colour online at www.interscience.wiley.com/journal/oa.
spinous apophysis of many thoracic vertebrae, where the supraspinous ligament inserts (Figure 13). This ligament acts in the flexoextension of the vertebral column; it is loose in extension and increases its strain during flexion of the trunk. Figure 3. The bones recovered from Burial no. 12. Those that present the lytic lesions are drawn in dark grey.
Discussion example, this is the case for spicular bony reactions on the supero-dorsal face of the proximal half of the right clavicle (Figure 12). Several exostoses were also identified in the
Figure 4. Lumbar vertebral arch showing the osteolytic lesions. This figure is available in colour online at www. interscience.wiley.com/journal/oa.
Copyright # 2007 John Wiley & Sons, Ltd.
The shape, size, absence of bone reaction, and distribution in the skeleton of the osteolytic lesions are similar to those produced by some neoplastic diseases (cancer), such as multiple myeloma (or myelomatosis), leukaemia or multiple metastasis (Ortner & Putschar, 1985; Strouhal, 1991, 1993; Rothschild et al., 1997, 1998; Sefca´kova´ et al., 2001). Multiple myeloma and leukaemia are malignant hematogenous diseases, considered forms of primary cancers. Their aetiology is unknown and they affect the hematopoetic cells located in bone marrow. Multiple myeloma produces an abnormal quantity of plasmocits, and generally affects individuals from 40 to 70 years of age. Leukaemia is characterised by the uncontrolled increase of blood cells. It affects individuals of all ages, adults and subadults. In both cases, the most usual macroscopic manifestation is the presence of numerous osteolytic lesions. In the case of multiple myeloma, these are generally spherical Int. J. Osteoarchaeol. 18: 492–506 (2008) DOI: 10.1002/oa
A Case of Metastasis in Hunter-Gatherers from Argentina
497
Figure 6. Proximal epiphysis of the left humerus showing multiple osteolytic fossae. This figure is available in colour online at www.interscience.wiley.com/journal/oa.
Figure 7. RX image of a dorsal vertebra with osteoclastic lesions with well-defined limits and without sclerotic borders (arrows).
Copyright # 2007 John Wiley & Sons, Ltd.
and homogeneous in size with clearly defined borders, whereas in leukaemia they are more elliptical and irregular. In both diseases, the most affected parts of the skeleton are those that have active bone marrow, especially the skull, vertebrae, ribs and long bone epiphyses (Ortner & Putschar, 1985; Rothschild & Rothschild, 1995; Rothschild et al., 1997, 1998, 2002; Roberts & Manchester, 1999). Neoplasia is a term that defines a mass of localised tissue whose cellular reproduction is not normal. Benign neoplasias cannot destroy surrounding cells or migrate to other parts of the body, while malignant neoplasias destroy normal tissues and produce new malignant outgrowths in different parts of the body, called metastases. In other words, multiple metastasis is a secondary manifestation of a neoplasia. Spreading can occur via the lymphatic system, but it is more frequently hematogenous. In the case of multiple metastases, those osseous areas with more vascularisation are the most affected (Morse, 1978; Aufderheide & Rodrı´guez-Martı´n, 1998; Eisenberg, 1998; Roberts & Manchester, 1999; Campillo, 2001; Ortner, 2003). Int. J. Osteoarchaeol. 18: 492–506 (2008) DOI: 10.1002/oa
498
Figure 8. RX image of the right scapula. The radiolucent zones are clearly defined (arrows).
In the majority of the cases it is not possible to identify precisely the disease that caused the lesions. Nevertheless, careful analysis of the type and distribution of the lesions, together with information about the sex and age of the individual, can sometimes contribute to the identification (Strouhal, 1991, 1993; Anderson et al., 1992; Rothschild et al., 1998, 2002; Ortner, 2003). There are a number of features that allow us to discard leukaemia as the main cause of the disease, such as for example the precise morphology and location of the lesions. In addition, intracortical reabsortion and radiolucent bands in the metaphyses are features generally present in skeletons with leukaemia (Steinbock, 1976; Rothschild et al., 1997; Eisenberg, 1998). Both are absent in this case. In reference to radiolucent bands, Rothschild et al. Copyright # 2007 John Wiley & Sons, Ltd.
L. H. Luna et al. (1997: 491) stated that ‘as the presence of metaphyseal bands has not been reported in metastatic cancer, then they may be helpful in distinguishing leukemia and metastatic cancer’. Moreover, it is possible to differentiate myeloma and leukaemia from secondary tumours because the two former conditions hardly ever affect the vertebral pedicle, especially in dorsal and lumbar vertebrae, due to its lack of bone marrow. On the other hand, metastatic cancer affects this area very frequently (Steinbock, 1976; Rothschild et al., 1997; Eisenberg, 1998), as in this skeleton (Figure 14). All of this evidence supports the interpretation that the lesions found in this individual are the product of some kind of neoplasia or cancer that produced secondary manifestations or metastasis in the skeleton, and that this was probably the cause of death of this man. Moreover, it can be stated that this man undertook activities that required strong use of several parts of the body during his healthy life. This can be inferred from the presence of many bony exostoses located in zones of muscular insertions. The enthesoexostoses identified (sensu Campo Martı´n, 1998) are located at the insertion of the sternocleidomastoideus muscle (Rouviere, 1980; Stone & Stone, 1990), and may be the consequence of muscular or subperiostic lesions, due to violent efforts and/or a systematic use of the muscles. The irritation could have produced the calcification of the hematoma adjacent to the lesion (Rogers & Waldron, 1995; Larsen, 2000). Other groups of lesions, identified in vertebrae, are compatible with systematic movements of flexoextension of the musculoskeletal complex of the column (Rouviere, 1980; Stone & Stone, 1990), and the presence of all the hypertrophic lesions of entheses suggests recurrent mechanic stress around the neck, pectoral girdle and trunk. There are different types of cancer that can produce secondary bony lesions or multiple metastasis. The most frequent types are prostate and breast cancer, although lung, kidney, thyroid gland and gastrointestinal tract cancer should also be taken into account, in that order (Gregg et al., 1982; Duhig et al., 1996; Roberts & Manchester, 1999; Ostendorf Smith, 2002; Ortner, 2003). In this case, prostate and breast cancer can be excluded as causes of these lesions, the first Int. J. Osteoarchaeol. 18: 492–506 (2008) DOI: 10.1002/oa
A Case of Metastasis in Hunter-Gatherers from Argentina
499
Figure 9. RX image of the proximal third of the right femur with several lytic areas in the neck and the greater trochanter (arrows).
because it mainly produces osteoblastic or both osteoblastic and osteoclastic bony reactions, very different from those observed in this case (Anderson et al., 1992; Wakely et al., 1995; Mays et al., 1996; Waldron, 1997), and the second because it is very uncommon for males to have breast cancer. Because of the wide spectrum of origins of this disease and the similarities of osseous manifestations, it would be very speculative to establish a narrower palaeopathological diagnosis regarding the kind of primary cancer that caused the lesions (Morse, 1978; Dastugue, 1980; Aufderheide & Rodrı´guez-Martı´n, 1998; Ortner, 2003). Although Dettwyler (1991: 375) has consistently demonstrated that ‘we are not justified in drawing conclusions either about the quality of life for disabled individuals in the past or about the motives or attitudes of the rest of the Copyright # 2007 John Wiley & Sons, Ltd.
community from skeletal evidence of physical impairment’, it is possible, evaluating the medical knowledge about the symptomatology and the sequence of the corporal deterioration suffered by people with similar diseases, to offer a hypothesis about the process that led to the death of this individual. Following Scheer & Groce (1988, in Dettwyler, 1991) and the World Health Organization, Dettwyler (1991) distinguished between the definitions of impairment, disability and handicap. She established that impairment is an abnormality or loss of any physiological or anatomical structure or function. Disability refers to the consequences of impairment, any restriction or lack of ability to perform an activity appropriate for non-impaired persons; and a handicap is the social disadvantage that results from an impairment or disability. As a consequence of this, the assumption that the survival Int. J. Osteoarchaeol. 18: 492–506 (2008) DOI: 10.1002/oa
500
L. H. Luna et al.
Figure 10. SEM image showing the rounded lesions in the cortical zone. This corresponds to the beginning of the destruction process.
of the individual provides enough evidence of compassion has been challenged. We could hardly ever know with certainty anything about the handicap consequence of this disability from archaeological records alone, but it is possible to obtain information about impairment, and then to infer the degree of disability of the individual, from the palaeopathological analysis (Dettwyler, 1991; Hawkey, 1998). Neoplastic diseases are generally long-term illnesses. In this case, the characteristics of the metastatic lesions are compatible with a terminal disease in the late phase of development which this individual suffered for a relative long period of time, probably several months. Because he did not receive any effective treatment, he progressively lost his muscular capacity, with a slow but constant increase in fatigue, weakness and pain all over his body. His vital functions gradually collapsed. During several years of his adult life, this individual probably undertook activities that required strong and systematic use of several muscles, mainly of the trunk, pectoral girdle and neck. Subsequently, he suffered an increasing muscular atrophy caused by the disease. Copyright # 2007 John Wiley & Sons, Ltd.
At the level of the broader social group, it is interesting to explore the consequences that the illness this person was suffering may have had for the group’s dynamics and mobility. This aspect is especially important because the people buried in this cemetery belonged to huntergatherer groups that had a high level of mobility and who maintained long-distance exchanges and interaction networks. This is supported by several kinds of evidence. One of them is the difference in the levels of carbon and nitrogen stable isotopes of some of the skeletons excavated, which indicate both a continental diet and a complement of about 20% marine consumption (Bero´n, 2004; Bero´n & Baffi, 2004). Another indicator is the presence of artefacts accompanying the burials, manufactured with raw materials from very distant areas. Among them there are lithic artefacts of orthoquartzite, a raw material whose outcrops are about 600 km to the east of this site. There are also pendants and beads made of shells of molluscs from the Atlantic coast. In addition, metal bijou from the trans-Andean region was recovered with the burials, between them a fragment of tupu made of silver using Int. J. Osteoarchaeol. 18: 492–506 (2008) DOI: 10.1002/oa
A Case of Metastasis in Hunter-Gatherers from Argentina
501
Figure 11. SEM image that shows the well-defined borders of several lytic fossae, without sclerotic borders and evidence of new bone formation. Black arrows point to the lytic lesions in the earlier stages of development, and white arrows, those at the end of the osteoclastic activity.
Figure 12. Proximal epiphysis of right clavicle, with spicular bony reaction in the supero-dorsal face. This figure is available in colour online at www.interscience.wiley.com/journal/oa.
Copyright # 2007 John Wiley & Sons, Ltd.
Int. J. Osteoarchaeol. 18: 492–506 (2008) DOI: 10.1002/oa
L. H. Luna et al.
502
Figure 13. Bony exostosis at the end of the spinous process of a dorsal vertebra. This figure is available in colour online at www.interscience.wiley.com/journal/oa.
It can be stated as a hypothesis that, as a consequence of his impairment, in the latest months of his life this individual may have needed the increasing assistance of other members of the social group in order to move and satisfy his basic needs. During the end of his disease, his disability was an impediment to participating in everyday activities (Dettwyler, 1991; Hawkey, 1998). The disease process was probably very shocking to the members of his family and his social group, because of his previous robusticity, but especially because in practically all medical cases, cognitive capacity is not affected. In the last days, the severity of the condition surely increased, and the dependence on other people may have been complete, implying that he could have required someone to supply him with food.
Conclusions prehispanic techniques, and a pendant made of copper, whose morphology is reminiscent of others from central Chile (Bero´n et al., 2002; Cimino et al., 2004; Bero´n & Gonza´lez, 2005; Cimino & Pastorino, 2005).
Burial no. 12 from Chenque I site contains a skeleton of a male that presents multiple osteolytic lesions in the vertebral column, ribs, pelvis and some long bone epiphyses. Many of
Figure 14. Pedicle of a lumbar vertebra, affected by osteoclastic destruction. This figure is available in colour online at www.interscience.wiley.com/journal/oa.
Copyright # 2007 John Wiley & Sons, Ltd.
Int. J. Osteoarchaeol. 18: 492–506 (2008) DOI: 10.1002/oa
A Case of Metastasis in Hunter-Gatherers from Argentina the bones were partially destroyed by taphonomic agents, due to the structural debilitation caused by the osteoclastic process. The lesions are compatible with secondary lesions consequent of some kind of neoplasia or cancer that caused the death of this man. Moreover, some hypertrophied zones of muscular attachment have been identified in the clavicle and vertebral column, caused by systematic mechanic stress to the neck, shoulder girdle and upper vertebral column during the life-span of this individual. There are very few cases of metastatic cancer throughout the world identified from bioarchaeological evidence, although the number of papers that evaluate this issue have substantially increased during the last 20 years (Dastugue, 1980; Waldron, 1987; Strouhal, 1991; Rothschild & Rothschild, 1995; Strouhal et al., 1996; Roberts & Manchester, 1999; Ostendorf Smith, 2002; Capasso, 2005). The identification of a case of metastatic cancer in the context of the Chenque I site is very important since this is the first case in Argentina in which it is possible to identify neoplastic disease in a prehistoric burial. When we examine the provenance of the cases of neoplasias in published papers from around the world and at different periods of time, it can be seen that the majority of these investigations identify this condition in human remains from medieval and modern Europe, and Predynastic and Dynastic Egypt, whereas hunter-gathererfisher societies are hardly ever represented (Aufderheide & RodrĹ´guez-MartĹ´n, 1998; Ortner, 2003; Capasso, 2005). Capasso (2005) extensively reviewed the cases of cancer detected in archaeological burials, and stated that the prevalence of primary and metastatic neoplasias was extremely low all around the world in premedieval times. Moreover, Strouhal (1998, 2001) stated that only during the first millennium AD, and especially after the Middle Ages, was there an increase in the frequencies of neoplastic diseases observed in bioarchaeological samples. We wonder whether this pattern reflects the real proportion in which these diseases are present in different societies, or the sample biases produced by dissimilar patterns of mobility and inhumation of the bodies. We suppose that this temporal pattern also reflects the assumptions made by the researchers, who consider the chance of detectCopyright # 2007 John Wiley & Sons, Ltd.
503
ing these diseases in archaeological human bones from ‘non-producer societies’ to be low. It may also reflect, in part, the theoretical idea, still implicitly held by some scholars, that huntergatherers were always in balance and harmony with their environment, and that particular situations of individual and population stress are only relevant in societies traditionally classified as stratified or ranked by social and political organisation and the existence of institutionalised hierarchies.
Acknowledgements Several institutions have contributed to this research through grants and logistic support: the National Council of Technical and Scientific Researches (CONICET), the University of Buenos Aires, the National Parks Administration (APN) and the Subsecretary of Culture of La Pampa province. Felix Acuto revised the translation into English. We thank Eugen Strouhal and two anonymous reviewers for their comments.
References Anderson T, Wakely J, Carter A. 1992. Medieval example of metastatic carcinoma: a dry bone, radiological, and SEM study. American Journal of Physical Anthropology 89: 309–323. DOI: 10.1002/ajpa. 20358. Aufderheide AC, RodrĹ´guez-MartĹ´n C. 1998. The Cambridge Encyclopedia of Human Paleopathology. Cambridge University Press: Cambridge. Bass WM. 1987. Human Osteology. A Laboratory and Field Manual. Special Pub. N 2. Missouri Archaeological Society: Columbia, MO. Bero´n MA. 2003. El Sitio Chenque I. Un cementerio de cazadores-recolectores en la Pampa Seca (Parque Nacional Lihue´ Calel, La Pampa, Argentina). Atek na 1: 241–272 (available from the author). Bero´n MA. 2004. Dina´mica poblacional y estrategias de subsistencia de poblaciones prehispa´nicas de la cuenca AtuelSalado-Chadileuvu´-Curaco´, Provincia de La Pampa. Unpublished PhD dissertation, Faculty of Philosophy and Letters, University of Buenos Aires, Argentina. Bero´n MA. 2005a. Circulacio´n de bienes como indicador de interaccio´n entre las poblaciones de la Pampa Int. J. Osteoarchaeol. 18: 492–506 (2008) DOI: 10.1002/oa
Occidental y sus vecinos. In Arqueologia en las Pampas, Bayo´n C, Gonza´lez I, Flegenheimer N, Pupio A, Frere M (eds). EDIUNS: BahĹ´a Blanca, Argentina. In press. Bero´n MA. 2005b. Integracio´n de evidencias para evaluar dina´mica y circulacio´n de poblaciones en las fronteras del RĹ´o Colorado. Actas de las VI Jornadas de ArqueologĹ´a de la Patagonia. Punta Arenas, Chile. In press. Bero´n MA, Baffi EI. 2004. Variabilidad de las estructuras mortuorias en el Holoceno TardĹ´o. Cuenca de los lagos Posadas y Salitroso (prov. de Santa Cruz) y a´rea de Lihue´ Calel (prov. de La Pampa). In Contra Viento y Marea. ArqueologĹ´a de Patagonia, Civalero MT, Ferna´ndez P, Guraieb AG (eds). Instituto Nacional de AntropologĹ´a y Pensamiento Latinoamericano and Sociedad Argentina de AntropologĹ´a: Buenos Aires; 387–402. Bero´n MA, Gonza´lez L. 2006. Ana´lisis de composicio´n de adornos meta´licos de un contexto funerario de cazadores-recolectores. El sitio Chenque I, provincia de La Pampa. In MetodologĹ´as CientĹ´ficas Aplicadas al estudio de los Bienes Culturales, Pifferetti A, Bolmaro R (eds). Humanidades y Artes Ediciones: Rosario, Argentina; 82–86. Bero´n MA, Luna LH. 2005a. Excavacio´n, conservacio´n y manejo de recursos culturales en el Parque Nacional Lihue´ Calel. El sitio Chenque I. Actas del XV Congreso Nacional de ArqueologĹ´a Argentina: RĹ´o Cuarto, Co´rdoba, Argentina. In press. Bero´n MA, Luna LH. 2005b. Modalidades de entierro en el sitio Chenque I. Diversidad y complejidad de los patrones mortuorios de los cazadoresrecolectores pampeanos. In Arqueologia en las Pampas, Bayo´n C, Gonza´lez I, Flegenheimer N, Pupio A, Frere M (eds). EDIUNS: BahĹ´a Blanca, Argentina. In press. Bero´n MA, Baffi EI, Molinari R, Barrientos G, Aranda CM, Luna LH. 2000. Estructuras Funerarias de Momentos TardĹ´os en Pampa-Patagonia. El Chenque de Lihue´ Calel. In Desde el PaĹ´s de los Gigantes. Perspectivas Arqueolo´gicas en Patagonia. National University of Southern Patagonia: Rio Gallegos, Argentina; 141–160. Bero´n MA, Baffi EI, Molinari R, Aranda CM, Luna LH, Cimino AO. 2002. El Chenque de Lihue´ Calel. Una Estructura Funeraria en las Sierras de la Vida. In Del Mar a los Salitrales. Diez Mil AnËœos de Historia Pampeana en el Umbral del Tercer Milenio, Mazzanti DL, Bero´n MA, Oliva F (eds). National University of Mar del Plata: Mar del Plata, Argentina; 171–184. Bero´n MA, Luna LH, Curtoni RP. 2005. SerranĹ´as pampeanas meridionales. Investigaciones arqueolo´gicas en el a´rea de Lihue´ Calel. In Incuapa - 10 anËœos, Politis GG (ed.). Monographic Series of INCUAPA Copyright # 2007 John Wiley & Sons, Ltd.
L. H. Luna et al. N 4. FACSO, UNICEN: OlavarrĹ´a, Argentina; In press. Bo¨ko¨nyi S. 1970. A new method for the determination of the number of individuals in animal bone material. American Journal of Archaeology 74: 291– 292. Buikstra JE, Ubelaker DH. 1994. Standards for Data Collection from Human Skeletal Remains. Arkansas Archaeological Survey Research Series No. 44: Fayetteville, Arkansas. Campillo D. 2001. Introduccio´n a la PaleopatologĹ´a. Ediciones Bellaterra: Barcelona. Campo MartĹ´n M. 1998. El Babel terminolo´gico: EntesopatĹ´as. BoletĹ´n de la Asociacio´n EspanËœola de PaleopatologĹ´a 18: 2–4. Capasso LL. 2005. Antiquity of cancer. International Journal of Cancer 113: 2–13. DOI: 10/1002/ijc.20610. Cimino AO, Pastorino G. 2005. De conchas y cordones conchiles: procedencia de las valvas utilizadas para la confeccio´n de los elementos de adorno del sitio Chenque I. In Arqueologia en las Pampas, Bayo´n C, Gonza´lez I, Flegenheimer N, Pupio A, Frere M (eds). EDIUNS: BahĹ´a Blanca, Argentina. In press. Cimino AO, Guastavino M, Velardez SI. 2004. Cuantas cuentas. . .! Elementos de adorno del sitio Chenque I, Parque Nacional Lihue´ Calel. Provincia de La Pampa. In Aproximaciones Contempora´neas a la ArqueologĹ´a Pampeana. Perspectivas Teo´ricas, Metodolo´gicas, AnalĹ´ticas y Casos de Estudio, MartĹ´nez G, Gutie´rrez MA, Curtoni RP, Bero´n MA, Madrid P (eds). Faculty of Social Sciences, University of the Center of Buenos Aires Province (UNCPBA): OlavarrĹ´a, Buenos Aires, Argentina; 259–273. Dastugue J. 1980. Possibilities, limits and prospects in paleopathology of the human skeleton. Journal of Human Evolution 9: 3–8. Dettwyler KA. 1991. Can paleopathology provide evidence for ‘‘compassion’’? American Journal of Physical Anthropology 84: 375–384. DOI: 10.1002/ ajpa.20358. Di Donato RM. 2005. Polvo al polvo. . . Variables tafono´micas humanas y no humanas. Su influencia en la alteracio´n y preservacio´n diferencial del registro bioarqueolo´gico en un sitio funerario. In Arqueologia en las Pampas, Bayo´n C, Gonza´lez I, Flegenheimer N, Pupio A, Frere M (eds). EDIUNS: BahĹ´a Blanca, Argentina. In press. Duhig C, Strouhal E, Neˆmeckova´ A. 1996. Case of a secondary carcinoma of Anglon-Saxon period from Edix Hill, Barrington, Cambridgeshire, England. Journal of Paleopathology 8: 25–31. Eisenberg RL. 1998. Atlas de Diagno´stico Diferencial por la Imagen. Ediciones Consulta: Buenos Aires. !
504
Int. J. Osteoarchaeol. 18: 492–506 (2008) DOI: 10.1002/oa
A Case of Metastasis in Hunter-Gatherers from Argentina Gregg JB, Steele JP, Bass WM. 1982. Unusual osteolytic defects in ancient South Dakota skulls. American Journal of Physical Anthropology 58: 243–254. DOI: 10.1002/ajpa.20358. Hawkey D. 1998. Disability, compassion and the skeletal record: using musculoskeletal stress markers (MSM) to construct an osteobiography from Early New Mexico. International Journal of Osteoarchaeology 78: 326–340. DOI: 10.1002/oa.755. Katz D, Suchey J. 1986. Age determination of the male os pubis. American Journal of Physical Anthropology 69: 427–435. DOI: 10.1002/ajpa.20358. Larsen CS. 2000. Bioarchaeology. Interpreting Behavior from the Human Skeleton. Cambridge University Press: Cambridge. Luna LH. 2003. Ana´lisis de restos o´seos humanos fragmentados procedentes de una estructura funeraria compleja: Sitio Chenque I (Parque Nacional Lihue´ Calel, provincia de La Pampa). Relaciones de la Sociedad Argentina de AntropologĹ´a XXVII: 145–161. Luna LH, Baffi EI, Bero´n MA. 2004. El rol de las estructuras formales de entierro en el proceso de complejizacio´n de las poblaciones cazadorasrecolectoras del Holoceno TardĹ´o. In Aproximaciones Contempora´neas a la ArqueologĹ´a Pampeana. Perspectivas Teo´ricas, Metodolo´gicas, AnalĹ´ticas y Casos de Estudio, MartĹ´nez G, Gutie´rrez MA, Curtoni RP, Bero´n MA, Madrid P (eds). Faculty of Social Sciences, University of the Center of Buenos Aires Province (UNCPBA): OlavarrĹ´a, Buenos Aires, Argentina; 61–73. Mays S, Strouhal E, Vyhna´nek L, Neˆmeckova´ A. 1996. A case of metastatic carcinoma of Medieval date from Wharram Percy, England. Journal of Paleopathology 8: 33–42. Mazzia N, Scabuzzo C, Guicho´n R. 2004. Sobre cra´neos, pelvis y otros huesos. Entierros humanos en el sitio El Guanaco. In Aproximaciones Contempora´neas a la ArqueologĹ´a Pampeana. Perspectivas Teo´ricas, Metodolo´gicas, AnalĹ´ticas y Casos de Estudio, MartĹ´nez G, Gutie´rrez MA, Curtoni RP, Bero´n MA, Madrid P (eds). Faculty of Social Sciences, University of the Center of Buenos Aires Province (UNCPBA): OlavarrĹ´a, Buenos Aires; 293–304. Morse D. 1978. Ancient Disease in the Midwest. Reports of Investigation N 15. Illinois State Museum: Springfield, IL. Orchard T. 2005. The use of statistical size estimations in minimum number calculations. International Journal of Osteoarchaeology 15: 351–359. DOI: 10.1002/oa.755. Ortner DJ. 2003. Identification of Pathological Conditions in Human Skeletal Remains. Academic Press: Florida. Ortner DJ, Putschar WGJ. 1985. Identification of Pathological Conditions in Human Skeletal Remains. SmithsoCopyright # 2007 John Wiley & Sons, Ltd.
505
nian Contributions to Anthropology 28. Smithsonian Institution: Washington, DC. Ostendorf Smith M. 2002. A probable case of metastasic carcinoma from the late prehistoric eastern Tennessee River Valley. International Journal of Osteoarchaeology 12: 235–247. DOI: 10.1002/oa.755. Roberts C, Manchester K. 1999. The Archaeology of Disease. Cornell University Press: New York. Rogers J, Waldron T. 1995. A Field Guide to Joint Diseases in Archaeology. John Wiley and Sons: Chichester. Rothschild BM, Rothschild C. 1995. Comparison of radiologic and gross examination for detection of cancer in defleshed skeleton. American Journal of Physical Anthropology 96: 357–363. DOI: 10.1002/ ajpa.20358. Rothschild BM, Hershkovitz I, Dutour O, Latimer B, Rothschild C, Jellema LM. 1997. Recognition of leukemia in skeletal remains: report and comparison of two cases. American Journal of Physical Anthropology 102: 481–496. DOI: 10.1002/ajpa.20358. Rothschild BM, Hershkovitz I, Dutour O. 1998. Clues potentially distinguishing lytic lesions of multiple myeloma from those of metastatic carcinoma. American Journal of Physical Anthropology 105: 241–250. DOI: 10.1002/ajpa.20358. Rothschild BM, Ruhli F, Rothschild C. 2002. Skeletal ´s clues apparently distinguishing Waldenstrom macroglobulinemia from multiple myeloma and leukemia. American Journal of Physical Anthropology 14: 532–537. DOI: 10.1002/ajpa.20358. Rouviere H. 1980. AnatomĹ´a Humana Descriptiva y Topogra´fica. Casa editorial Bailly-Bailliere S.A: Madrid. Sefca´kova´ A, Strouhal E, Neˆmeckova´ A, Thurzo M, StassĹ´kova´-Stukovska´ D. 2001. Case of metastatic carcinoma from end of the 8th–early 9th century Slovakia. American Journal of Physical Anthropology 116: 216–229. DOI: 10.1002/ajpa.20358. Steinbock T. 1976. Paleopathological Diagnosis and Interpretation. Ch. C. Thomas: Illinois. Stone RJ, Stone JA. 1990. Atlas of the Skeletal Muscles. Wm. C. Brown Publishers: Dubuque. Strouhal E. 1991. A case of primary carcinoma from Christian Sayala (Egyptian Nubia). Journal of Paleopathology 3: 151–166. Strouhal E. 1993. A case of metastatic carcinoma from Christian Sayala (Egyptian Nubia). Anthropologischer Anzeiger 51: 97–115. Strouhal E. 1998. Survey and analysis of malignant tumors of past populations in England and Scotland. Journal of Paleopathology 10: 101–109. Strouhal E, Vyhna´nek L, Hora´ckova´ L, Benesova´ L, Neˆmeckova´ A. 1996. Malignant tumors affecting the people from the ossuary at Krtiny (Czech Republic). Journal of Paleopathology 8: 5–24. Int. J. Osteoarchaeol. 18: 492–506 (2008) DOI: 10.1002/oa
506 Todd T. 1921a. Age changes in the pubic bone. I: the male white pubis. American Journal of Physical Anthropology 3: 285–334. Todd T. 1921b. Age changes in the pubic bone. III: the pubis of the white female. IV: the pubis of the female white-negro hybrid. American Journal of Physical Anthropology 4: 1–70. Ubelaker D. 1974. Reconstruction of demographic profiles from ossuary skeletal samples. A case study from the Tidewater Potomac. Smithsonian Contributions to Anthropology 18. Smithsonian Institution Press: Washington, DC.
Copyright # 2007 John Wiley & Sons, Ltd.
L. H. Luna et al. Wakely J, Anderson T, Carter A. 1995. A multidisciplinarian case study of prostatic (?) carcinoma from Mediaeval Canterbury. Journal of Archaeological Science 22: 469–477. DOI: 10.1006/ jasc.2000.0645. Waldron T. 1987. Lytic lesions in a skull: a problem in diagnosis. Journal of Paleopathology 1: 5–14. Waldron T. 1997. A nineteenth-century case of carcinoma of the prostate, with a note on the early history of the disease. International Journal of Osteoarchaeology 7: 241–247. DOI: 10.1002/oa.755.
Int. J. Osteoarchaeol. 18: 492–506 (2008) DOI: 10.1002/oa