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Neck mass and tracheostomy in a young lady depicted by Piero di Cosimo

  • Juan J. GrauEmail author
  • Miguel Caballero
  • Cristina Garrido
  • Sílvia Canalda
  • Antoni Trilla
Historical Note


Among surgical procedures currently in use, tracheostomy has a particularly long history. The first written description of the procedure is due to Brasavola, and dates from 1546. Piero di Cosimo (1462–1522) was an early Renaissance painter who painted a work traditionally known as Cephalus and Procris or The Death of Procris (1495–1500). In this painting, a vertical tracheostomy can be observed in a young woman lying on the ground. A giant mass can be seen in the lower left neck with superficial venous vessels, suggesting a thyroid malignancy. This appears to be the first detailed depiction of a malignant cervical mass and a possibly therapeutic tracheostomy. We discuss the clinical differential diagnosis and also make some comments from an art history perspective.


Neck Mass Tracheostomy Thyroid cancer Piero di Cosimo 



We thank doctors Jaume Capdevila (medical oncologist); Irene Halperin (endocrinologist); Manuel Bernal, Jose-Luis Blanch, and Isabel Vilaseca (head and neck surgeons); Carles Conill, and Izascun Valduvieco (radiotherapy oncologists), Armando Lopez-Guillermo (hematologist); Francisco Carmona (gynecologist); and Francisco Avia (clinical photographer) for their help and advice in the evaluation of the images studied.

Supplementary material

42000_2019_146_MOESM1_ESM.pdf (742 kb)
ESM 1 (PDF 741 kb)
42000_2019_146_MOESM2_ESM.pdf (165 kb)
ESM 2 (PDF 164 kb)
42000_2019_146_MOESM3_ESM.pdf (134 kb)
ESM 3 (PDF 134 kb)


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Copyright information

© Hellenic Endocrine Society 2019

Authors and Affiliations

  1. 1.Medical Oncology Department, Hospital Clinic of BarcelonaUniversity of BarcelonaBarcelonaSpain
  2. 2.Head and Neck Surgery Department, Hospital ClinicUniversity of BarcelonaBarcelonaSpain
  3. 3.Art History DepartmentUniversity of BarcelonaBarcelonaSpain
  4. 4.Epidemiology Department, Hospital ClinicUniversity of BarcelonaBarcelonaSpain

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