Metastatic Carcinoma with Associated Lymphoadenopathy and Acquired Horner’s Syndrome Portrayed in a Third Century CE Roman Bust

Unilateral Facial Asymmetry in a 40 BCE Roman Carved Head

“…5 The observation of the right lateral and the frontal view of the head excludes the presence of a preauricular lump or of a lymphoadenopathy potentially due to metastatic carcinoma; 5 such a condition has been appreciated in a Roman bust dated to the 3rd century CE. 6 As to malignant otitis externa [7][8] and acute otitis media, 9-12 their symptomatology is rarely associated with the features displayed by carved head; the same is for tooth abscesses. 13 Although the carved head displays some features consistent with Bell's palsy, 14 the presence of facial asymmetry, reduced size of facial muscles, abnormality of the outer ears (reduced size and displacement and ear tags), chin asymmetry, orbital dystopia, makes a retrospective diagnosis of mild hemifacial microsomia with facial nerve paralysis highly likely.…”

“…Such a careful reproduction of the facial features of ancient individuals makes Roman Republican busts (1st century BCE to 30 BCE) excellent tools for the retrospective diagnosis of pathologic conditions. 6,17,18 In the carved bust we examined, a diagnosis of unilateral facial asymmetry and peripheral CN VII palsy, possibly due to mild hemifacial microsomia, is proposed. Given the strict adherence to reality of the Republican Roman portraiture, we surmise that this condition endured for a sufficiently long time period to become a distinctive mark of the man.…”

“…Such a careful reproduction of the facial features of ancient individuals makes Roman Republican busts (1st century BCE to 30 BCE) excellent tools for the retrospective diagnosis of pathologic conditions 6,17,18 . In the carved bust we examined, a diagnosis of unilateral facial asymmetry and peripheral CN VII palsy, possibly due to mild hemifacial microsomia, is proposed.…”

“…The observation of the right lateral and the frontal view of the head excludes the presence of a preauricular lump or of a lympho-adenopathy potentially due to metastatic carcinoma; 5 such a condition has been appreciated in a Roman bust dated to the 3rd century CE 6 …”

A Disfiguring Facial Lesion in an Ottoman-Styled Warrior of the Late 15th Century Volckamer Epitaph (Germany)

“…This holds particularly true for both Roman antiquity (between 3rd to 1st centuries BCE and 3rd century CE) 1 and Renaissance. In these periods, the elaboration of individual body forms and facial traits reached extreme verism in the representation of both healthy and pathologic conditions 2,3 …”