Carlos Armando Rodríguez

Possible case of sirenomelia in the Tumaco-Tolita pottery pre-Columbian culture, 2000 years before the epidemic focus of sirenomelia in Cali-Colombia.

follow up of the ECLAMC (Latin-American Collaborative Study of Congenital Malformations), an epidemic focus of sirenomelia, where during a 55-day period between September 12, 2004, and February 2, 20005, 1,064 children were born and four cases presented this rare disease, whichwas considered unusual and suggesting the presence of a cluster [Castilla et al., 2008]. We present a pottery sample from the Tumaco-Tolita culture close to 2,000 years old with a possible sirenomelia that presents phenotypical features like fused lower limbs, probably constituting the oldest evidence of this disease in the pre-Hispanic LatinAmerican and past world. The Tumaco-Tolita culture inhabited the geo-historic region of the Pacific Colombo-Ecuadorian coast during the years 300 BCE to 600 CE (Fig. 1). This culture was characterized for depicting with impressive realism the different pathologies affecting their population. In their pottery work, they show evidence of genetic illnesses like Down syndrome and achondroplasia, congenital malformations, and health states like maternity, aging processes, and death [Bernal and Brice~ no, 2006; Pachajoa et al., 2007].

Holoprosencephaly with premaxillary agenesis in a prehistoric skull

We present a 1500-year-old skull of a 5-year-old child (ossification and tooth eruption), who presented a premaxillary agenesis and ocular hypotelorism suggesting the diagnosis of semilobar HPE. The presentation of HPE has been extensively studied by Cohen (2009). He describes cyclopia as the main manifestation. 4 Although the presence of HPE and premaxillary agenesis has been reported, this case corresponds to the Lima culture, a pre-Inca culture that developed in the central coast of Peru (between A.D. 100 to A.D. 650). In our case it was not possible to determine the aetiology, considering that it was an indigenous community that inhabited Peru 1500 years ago. Different representations of human malformations in community-made ceramics South American Pacific coast with ornaments and costumes of the elite, suggest that people with congenital malformations had some preferential management in these communities. 5

Microsomía hemifacial (espectro oculoauriculovertebral) en la cerámica de la cultura prehispánica tumaco-tolita (300 a.C.-600 d.C.)

La microsomia hemifacial es un defecto congenito que invo-lucra los derivados del primero y segundo arco branquial. El espectro clinico fue mas tarde extendido e incluye una varie-dad de anomalias oculares, auriculares y vertebrales y fue renombrado apropiadamente como espectro oculoauricu-lovertebral (OAVS) por su asociacion con otras anomalias craneofaciales, cardiacas, vertebrales y del sistema nervioso central

Siamese twins with craniofacial duplication and bilateral cleft lip/palate in a ceramic representation of the Chimú culture (Peru): a comparative analysis with a current case.

Craniofacial duplication or diprosopus is a very rare malformation that is present in approximately 0.4% of conjoined twins. Here is presented a case of craniofacial duplication in association with bilateral cleft lip/palate in both heads found in a ceramic representation from the early Chimú culture from Peru. A comparative analysis is made with a current case of a 28-week-old fetus with similar characteristics. After reviewing the medical literature on conjoined twins, very few reports of facial cleft in both twins were found, with no reports at all of bilateral cleft lip/palate. This ceramic crock is considered one of the first representations suggestive of craniofacial duplication, and probably the first reporting it in association with facial cleft.

Síndrome de Crouzon en poblaciones prehispánicas de Suramérica

El sindrome de Crouzon es una enfermedad caracterizada por craneosinostosis que causa alteraciones secundarias de los huesos faciales y de la estructura facial. Las caracteristicas comunes incluyen hipertelorismo, exoftalmos y estrabismo externo, la nariz de «pico de loro», labio superior corto, hipoplasia maxilar, un prognatismo mandibular relativo, cierre prematuro de las suturas craneales, hipoplasia del tercio medio facial, deformidades orbitales, y otras anomalias ocasionales asociadas1. Esta patologia es causada por mutaciones en el gen FGFR2, asignado a locus cromosomico 10q25-10q26 con una prevalencia de aproximadamente 1 por cada 25.000 recien nacidos vivos2. El sindrome de Crouzon es heredado como un rasgo autosomico dominante, con penetrancia completa y expresividad variable, pero el 3060% de los casos son esporadicos y representan mutaciones nuevas2. En 1912 un cirujano frances llamado Crouzon describio en una edicion de de Bulletins et Memoires Societe Medicale des Hopitaux de Paris una condicion craneofacial hereditaria que actualmente recibe su nombre. El caso inicial consistio en una madre y su hijo, ambos con caracteristicas clinicas de sindrome de Crouzon3. Este sindrome parece haberse presentado entre las poblaciones prehispanicas que ocuparon la costa pacifica de Colombia, Ecuador y Peru, y que fueron las creadoras de la cultura jerarquico-cacical Tumaco-La Tolita (300 a.C.-600 d.C.)4 y la sociedad estatal temprana Moche (200-850 d.C.)5. Estudios iconograficos y medicos recientes han revelado la