Enlarged sella turcica in a male from 18th-century Cracow, Poland: Diagnostic challenges in the identification of a probable pituitary macroadenoma.

OBJECTIVE

Disturbances in the structure of the sella turcica are recognised markers of pituitary pathology in clinical diagnostics but remain rarely evaluated in archaeological human remains. This study aims to provide a morphometric and morphological analysis of an enlarged sella turcica in an individual recovered from an 18th-century crypt.

MATERIALS: 45-55-year-old male from the burial crypts of the Church of St Francis of Assisi in Cracow, Poland

METHODS

The skull was examined using high-resolution computed tomography (CT) and endoscopic inspection. Linear dimensions were obtained following established radiological protocols and compared with modern reference data.

RESULTS

CT imaging revealed pronounced enlargement of the sella turcica in all dimensions and a full-thickness erosive defect of the dorsum sellae with smooth, scalloped margins, consistent with chronic pressure-induced remodelling. No additional skeletal changes indicative of hormonally active pituitary disease were observed.

CONCLUSIONS

The findings are most compatible with a long-standing benign non-functioning pituitary macroadenoma and demonstrate that subtle endocranial changes can be reliably identified using advanced imaging techniques in archaeological material.

SIGNIFICANCE: This study addresses a clear gap in palaeopathological research by providing rare, imaging-based evidence of pituitary-region pathology in archaeological remains. It demonstrates the diagnostic potential of systematic sella turcica assessment and supports the integration of clinical radiological criteria into palaeopathological practice, with broader implications for identifying endocrine disorders in past populations.

SUGGESTIONS FOR FURTHER RESEARCH: Future studies should integrate biomolecular and histological approaches and investigate larger skeletal series to establish the prevalence and variability of pituitary-related changes in past populations.