Hibernoma in the Thoracic Back Muscle Accompanied by Neurilemmoma

Kim, Hyun Su; Lee, Sang Gu; Son, Seong; Lee, Keun

doi:10.14245/kjs.2012.9.4.362

Cited by 3 publications

(1 citation statement)

References 10 publications

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“…On the other hand, this increased vascularity may help to differentiate hibernomas from other soft-tissue tumors. Some authors recommend arterial embolization to be carried out before the surgery in order to minimize the bleeding that may occur during the intervention 7 . There are no literature evidence that preoperative embolization of a hibernoma affects the surgical outcome, although it may help the surgeon to perform complete resection without the tumor fragmentation 8 .…”

Section: Discussionmentioning

confidence: 99%

Large hibernoma of the neck: A case report

Mikić¹,

Folić²,

Boričić

et al. 2019

VOJNOSANIT PREGL

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Introduction. A hibernoma is a rare benign tumor derived from vestigial remnants of brown adipose tissue. In neonates this tissue makes up about 5% of the body mass and its amount greatly decreases after birth, persisting only in scattered subcutaneous areas. In rare cases, brown fat continues to grow leading to a hibernoma that may be located in the head and neck. We present an illustrative case of a large hibernoma of the neck with infraclavicular extension and discuss about diagnostic and treatment difficulties. Case report. A 29-year-old male presented with large, slowly progressive, painless neck mass that was noticed 6 months earlier. Computed tomography (CT) and magnetic resonance (MR) showed a well-vascularized, soft tissue tumor of the lateral region of the neck and supraclavicular fossa with extension below clavicle. Treatment included arterial embolization followed by challenging surgical removal of the tumor. Dissection was performed at III, IV and V levels of the neck, making complete resection possible without the tumor fragmentation or major blood vessels and cranial nerves injuries. The final diagnosis of the hibernoma was made by histopathological analysis. The patient had no signs of recurrence during three-year follow-up. Conclusion. Although the CT scan and MR may raise the suspicion, hibernoma is definitely diagnosed by a pathologist. It is very important to exclude the malignant processes, foremost liposarcoma. The tumor fragmentation during surgery should be avoided because the high vascularity of the tumor tissue carries a substantial risk for hemorrhage. Our experience with preoperative embolization and complete tumor resection in this case showed positive impact on the final outcome.

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Section: Discussionmentioning

confidence: 99%

Large hibernoma of the neck: A case report

Mikić¹,

Folić²,

Boričić

et al. 2019

VOJNOSANIT PREGL

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Paraspinal hibernoma: Grand Round presentation of a rare benign adipocytic tumor

et al. 2017

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Hibernoma Mimicking Atypical Lipomatous Tumor

Hmada

Schaefer

Fletcher

2018

American Journal of Surgical Pathology

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Hibernoma is a benign adipocytic tumor with predilection for subcutaneous tissue of the thigh, upper trunk, and neck of middle-aged adults. 11q13 rearrangement resulting in MEN1/AIP codeletion is characteristic. Hibernomas are composed, in varying proportions, of brown fat cells, mature adipocytes, and microvacuolated lipoblast-like cells. Examples containing predominantly multivacuolated lipoblast-like cells are uncommon and distinction from atypical lipomatous tumor (ALT) is important for clinical management. We herein present the clinicopathologic features of 64 hibernomas histologically mimicking ALT. MDM2 and CDK4 immunohistochemistry as well as MDM2 fluorescence in situ hybridization were performed in a subset of cases. Clinical and follow-up information were obtained from referring pathologists. Thirty-four patients were male and 30 female, with a median age of 43 years (range, 24 to 78 y). The tumors were well circumscribed and mostly deeply located (53/64 cases, 83%) with a median tumor size of 12.9 cm (range, 3.5 to 23 cm) and predilection for the thigh (42/64 cases, 66%). Histologically, large cells with prominent lipoblast-like cytoplasmic fatty vacuoles and small central nuclei were present to a prominent degree in all cases, along with mature univacuolated adipocytes and smaller numbers of large, finely vacuolated cells with eosinophilic granular cytoplasm. Nuclear atypia and mitoses were absent. None of the 39 cases tested showed CDK4 and MDM2 overexpression or MDM2 amplification. Follow-up, available for 16/64 cases (median, 47 mo; range, 1 to 165 mo), revealed no recurrences or metastases. Hibernoma mimicking ALT shows predilection for deep soft tissue, especially in the thigh. These tumors behave in a benign manner and MDM2/CDK4 negativity may be useful in excluding ALT.

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Hibernoma in the Thoracic Back Muscle Accompanied by Neurilemmoma

Cited by 3 publications

References 10 publications

Large hibernoma of the neck: A case report

Large hibernoma of the neck: A case report

Paraspinal hibernoma: Grand Round presentation of a rare benign adipocytic tumor

Hibernoma Mimicking Atypical Lipomatous Tumor

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