A likely case of goiter in the Madonna col Bambino dormiente (1465/1470) by Andrea Mantegna (1431–1506)

The Gemälde Gallerie in Berlin exhibits the famous painting Madonna col Bambino dormiente (Eng. Madonna with sleeping child, Fig. 1) painted around 1465/1470 by Andrea Mantegna (1431–1506). A common theme of the Italian Renaissance, the Madonna with child was often studied and represented by Mantegna throughout his life. In comparison with previous representations characterized by a stiff and awkward rendering of shapes, this is a more intimate and private interpretation of the divine duo with a softer pictorial and more harmonious compositional quality. The particular attention paid to representing reality reveals that the Virgin Mary shows an enlarged neck, with a protruding ovoidal mass. Elsewhere identified lobulations being absent, the pictorial evidence alone would not allow to formulate a clear-cut semeiological diagnosis of goiter and more differential diagnoses could be considered, e.g., lipoma, cyst, abscess, lymphadenopathy, carotid artery aneurism, etc. Nonetheless, the very suggestive anatomical position and the fact that several more examples by different artists of Renaissance [1, 2] have been identified as portrayed with the typical pathological morphology of a goitrous enlargement strongly point in that interpretative direction. Another Madonna with child in the Boston Museum of Fine Arts by one of Mantegna’s followers has also been identified as a representation of goiter, which highlights how the painter and his school have not ignored this pathological trait, as much as they did not ignore pathological temporal arteries or rickets