Malformations of the axial skeleton in Museum Vrolik I: Homeotic transformations and numerical anomalies

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Abstract
The Museum Vrolik collection of anatomical specimens in Amsterdam, The Netherlands, comprises over 5,000 specimens of human and animal anatomy, embryology, pathology, and congenital anomalies. Recently, we rediagnosed a subset of the collection comprising dried human trunk skeletons and cranial base preparations presenting with homeotic transformations (vertebral phenotypic shifts) and numerical vertebral anomalies. We identified 11 trunk skeletons with either anterior or posterior homeotic transformations (AHT or PHT), 5 trunk skeletons with either less or more than the normal number of vertebrae, and well over a hundred cranial base preparations with either AHT (atlas‐assimilation) or PHT (occipital vertebra). We found that, although homeotic transformations and numerical anomalies are distinct conditions, both can be described in terms of mismatch between homeotic patterning and morphological segmentation of the paraxial mesoderm. Therefore these two processes are perhaps not as tightly linked as they may seem on the basis of recent molecular studies. In homeotic transformations there is a constant mismatch between homeotic patterning and morphological segmentation throughout the affected region of the vertebral column. In numerical anomalies there is a variable mismatch between homeotic patterning and morphological segmentation, either because of stretching or squeezing of the homeotic pattern or because of oligo‐ or polysegmentation of the presomitic mesoderm (PSM). Homeotic transformations of the axial skeleton have an incidence of about 1%–5%, apart from their occurrence in malformation syndromes. Of the various etiological possibilities, explaining their frequent but mostly sporadic occurrence, maternal hyperthermia seems an attractive candidate.