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Images in thorax
Leonardo da Vinci and the first portrayal of pectus excavatum
  1. Hutan Ashrafian
  1. Department of Surgery and Cancer, Imperial College London, London, UK
  1. Correspondence to Hutan Ashrafian, The Department of Surgery and Cancer, Imperial College London, 10th Floor QEQM-Building, Praed Street, London W2 1NY, UK; h.ashrafian{at}

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Studying one of Leonardo da Vinci's images from 1510, I note for the first time that there is an image of pectus excavatum (figure 1) in an elderly individual. This is unlikely to be artistic inaccuracy as his images of others subjects do not reveal a similar pathology. Pectus excavatum was until now first accredited to Johannes Schenck (1530–1598)1 reporting in the mid-to-late 16th century and Johann Bauhin (1541–1613) who described a patient with this disorder in 1594.2 Leonardo da Vinci's portrayal of pectus excavatum predates these by eight decades; rendering it the first ever depiction of this disorder.

Figure 1

Image of the upper thorax demonstrating pectus excavatum. Leonardo da Vinci, circa 1510–1511. Supplied by Royal Collection Trust/© HM Queen Elizabeth II 2013.


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  • Competing interests None.

  • Provenance and peer review Not commissioned; internally peer reviewed.