A case of Multiple Myeloma from 19th century North America: Aligning the clinical and archaeological records.

The first archaeological case of multiple myeloma (MM) from historic period North America is presented. Only 49 cases of MM have been reported from archaeological contexts and recent reviews have alternately rejected either 24 of the cases or all 49 cases and found them all to more likely be cases of metastatic carcinoma (MC). The trend in the debate over the interpretation of these cancers is that MC is an ancient disease while MM is likely a disease of modernity. MM was first recognized as a distinct form of cancer in 1873 with only 17 cases reported by 1900. The first North American clinically identified case of MM was reported in 1894. This study supports the suggestion that MM is a disease of modernity with the etiology likely linked to industrialization. The archaeological case presented here was interred circa 1880, in the same time frame that MM is recognized as a distinct disease and briefly predates the clinical reporting of MM in the US. Of note, the individual is associated with an institution that served societal dependents. As catchall warehouses for dependency it is not surprising to find conditions reflective of senescence. Such institutions provided hospice care for the terminally ill and can serve, as in this case, to align the archaeological and clinical records.