Intraosseous Hibernoma: A Rare and Unique Intraosseous Lesion

송보람,문경철,류혜진,이철 대한병리학회 2017 Journal of Pathology and Translational Medicine Vol.51 No.5

Background: Hibernoma is a rare benign tumor of adults that is composed of multivacuolated adipocytes resembling brown fat cells. Hibernoma typically occurs in soft tissue, and intraosseous examples are very rare. Intraosseous hibernomas can radiologically mimic metastatic carcinoma and other tumorous conditions. Methods: To collect the intraosseous hibernomas, we searched the pathologic database and reviewed the hematoxylin and eosin (H&E)–stained slides of bone biopsy samples performed to differentiate radiologically abnormal bone lesions from 2006 to 2016. A total of six intraosseous hibernoma cases were collected, and clinical and radiological information was verified from electronic medical records. H&E slide review and immunohistochemical staining for CD68, pan-cytokeratin, and S-100 protein were performed. Results: Magnetic resonance imaging of intraosseous hibernomas showed low signal intensity with slightly hyperintense foci on T1 and intermediate to high signal intensity on T2 weighted images. Intraosseous hibernomas appeared as heterogeneous sclerotic lesions with trabecular thickening on computed tomography scans and revealed mild hypermetabolism on positron emission tomography scans. Histopathologically, the bone marrow space was replaced by sheets of multivacuolated, foamy adipocytes resembling brown fat cells, without destruction of bone trabeculae. In immunohistochemical analysis, the tumor cells were negative for CD68 and pan-cytokeratin and positive for S-100 protein. Conclusions: Intraosseous hibernoma is very rare. This tumor can be overlooked due to its rarity and resemblance to bone marrow fat. Pathologists need to be aware of this entity to avoid misdiagnosis of this rare lesion.

Surgical Management of Residual or Recurred Hibernoma of the Neck

Kim Young Chul,Koh Jiwon,Kwon Seong Keun 대한후두음성언어의학회 2023 대한후두음성언어의학회지 Vol.34 No.2

A 16-year-old girl was incidentally found to have a mediastinal lipogenic mass, which was confirmed as a hibernoma on biopsy. Mediastinal mass excision with full sternotomy was performed, and follow-up chest computed tomography at postoperative 1 year revealed a residual or recurred mass at the left neck (level VI). Consequently, left level-VI neck dissection was performed, and the biopsy also confirmed hibernoma. During neck dissection, an electromyography tube was used to monitor the recurrent laryngeal nerve, and complete removal was achieved without damage to the vagus nerve, carotid vessels, or thyroid gland. When managing cervical lipogenic tumors, clinical suspicion is necessary, followed by radiological and pathological evaluations to differentiate malignancies. If a hibernoma is suspected, en bloc resection of the tumor is crucial to prevent hemorrhage and recurrence. Cervical hibernoma can cause symptoms such as dysphagia, weight loss, and exertional dyspnea owing to its mass effect. Surgeons should be cautious during tumor removal to protect the recurrent laryngeal nerve. We successfully removed the residual or recurred hibernoma in the neck without complications.

A Case Report of Axillary Hibernoma: US, CT, MR, and Histopathologic Findings

Park Ji Yeon,Yi Seong Yoon,Lee Ji Young,Kwon Tae Jung 대한영상의학회 2022 대한영상의학회지 Vol.83 No.2

Hibernoma is a rare benign tumor of brown adipose tissue. Herein, we report a case of axillary hibernoma in a 53-year-old female and discuss the various radiologic findings. The US revealed a 4.5-cm well-defined oval heterogenous hyperechoic mass in the right axilla with anterior displacement of the axillary vessels. Non-enhanced chest CT showed a 5.0-cm well defined, oval, and low-attenuated mass. MRI demonstrated a 5.5-cm mass with heterogeneous intermediateto- high signal intensity on T1-and T2-weighted images and irregular enhancement at the peripheral portion. The patient underwent an US-guided core needle biopsy and the final diagnosis was hibernoma.

Hibernoma: Intense Uptake on F18-FDG PET/CT

Kim, Jong Deok,Lee, Hang Woo The Korea Society of Nuclear Medicine 2012 핵의학 분자영상 Vol.46 No.3

Hibernoma is a rare benign but metabolically active tumor of brown fat origin, that can have cross-sectional imaging characteristics similar to those of other fat-containing tumors, such as lipomas and liposarcomas, and its presence can lead to false-positive interpretation by exhibiting increased F18-fluorodeoxyglucose (F18-FDG) activity. A 46-year-old woman was diagnosed with dermatofibrosarcoma protuberans underwent F18-FDG positron emission tomography/computed tomography (PET/CT) for detecting recurrence after excision. F18-FDG PET/CT showed incidental intense uptake in the back in addition to increased F18-FDG uptake at the previous lesion site. To our knowledge, this is the first case report of intense F18-FDG uptake in hibernoma in Korea.

대요근에서 발생한 동면선종: 증례 보고

김기홍,허진,윤춘식 대한영상의학회 2007 대한영상의학회지 Vol.56 No.1

Hibernoma is a rare, benign, soft tissue tumor that is composed of brown fat. We report here on a case of hibernoma that arrose from the right psoas muscle along with the imaging features on computed tomography (CT), magnetic resonance imaging (MRI), and 2-deoxy-2 (F-18) fluoro-D-glucose positron emission tomography (FDGPET). We suggest that a fat-containing mass with a curvilinear intratumoral vessel on the CT and MRI scans provides diagnostic clues for making the differential diagnosis of hibernoma, although these features may mimic malignancy. 동면선종은 갈색지방으로 이루어진 드문 양성 연부조직종양이다. 본 저자들은 우측 대요근에서 발생한 동면선종의 컴퓨터단층촬영(CT), 자기공명영상 (MRI) 및 18 FDG- 양전자단층촬영의 영상소견을 증례 보고하고자 한다. 본 증례를 통하여 지방 성분을 포함한 종양이 악성을 시사하는 소견이 있다고 하더라도 종양 내의 특징적인 혈관을 컴퓨터단층촬영(CT) 및 자기공명영상(MRI) 에서 관찰한다면 동면선종을 감별진단에 포함해야 하겠다.

Hibernoma in the Thoracic Back Muscle Accompanied by Neurilemmoma

김현수,이상구,손성,이근 대한척추신경외과학회 2012 Neurospine Vol.9 No.4

Hibernoma is a very rare, benign soft fatty tumor that derived from remnants of fetal brown tissue. The following case of hibernoma break out occurred from a patient who had received surgical resection of neurilemmoma. There has never been a case that reported about hibernoma accompanied by neurilemmoma. It is anticipated that this experience would be helpful to other physicians who are interested in this rare type of tumor.

동면종의 압착도말 세포소견 -1예 보고-

최준혁,신덕섭,Choi, Joon-Hyuk,Shin, Duk-Seop The Korean Society for Cytopathology 2008 대한세포병리학회지 Vol.19 No.2

Hibernoma is a rare, benign adipose tumor composed of brown fat cells with eosinophilic granular or multivacuolated cytoplasm. The cytologic features of hibernoma have been rarely reported and may mimic other polygonal cell neoplasms. We report the imprint cytologic features of a case of hibernoma in the left thigh of a 68-year-old woman. Microscopic examination showed large, round, or polygonal brown fat cells. The cells were arranged in fragments or clusters. The nuclei were uniformly round with finely granular chrornatin. The cytoplasm was multivacuolated or univacuolated. The abundant eosinophilic granular cytoplasm was also present. No nuclear atypia were present. Immunohistochemical staining showed that cells were positive for S-100 protein.

우측 견관절 부위에 발생한 동면종

강호정(Ho-Jung Kang),황보현(Bo-Hyun Hwang),정민(Min Jung),구자승(Ja-Seung Koo),신규호(Kyoo-Ho Shin),한수봉(Soo-Bong Hahn),김성재(Sung-Jae Kim) 대한견주관절의학회 2009 대한견주관절학회지 Vol.12 No.1

목적: 동면종은 혈관분포가 풍부한 갈색지방조직으로 이루어진 매우 희귀한 양성 연부조직 종양이다. 대상 및 방법: 조직학적으로 악성의 성향을 보이지는 않으나, 진단 방법에 있어서 자기 공명 영상이나 조영 증강 컴퓨터 단층 촬영상에서 지방육종 등의 악성 종양과 구별되지 않는 특징을 갖기 때문에, 수술적 방법을 통한 조직 생검이 치료 방법이다. 결과: 조직병리학적으로 갈색지방세포로 이루어져 있기 때문에, 백색지방세포 조직과 달리 구성 세포들은 다각형 모습의 다공포성이며, 핵이 중앙부에 위치하고 과립성의 세포질을 갖고 있다. 결론: 본 증례에서는 조직학적으로 확인된 우측 견관절의 동면종에 대해서 보고하고자 한다. Purpose: Hibernoma is a very rare benign soft tissue tumor of the hypervascularized brown fat tissue with no malignant potential. Materials and Methods: However, it is difficult to differentiate a hibernoma from other malignant tumors, such as liposarcoma using computed tomography and magnetic resonance imaging, and a surgical resection with histological confirmation is the treatment of choice. Results: Histopathologically, hibernoma is composed of brown adipose cells that are polygonal and multivacuolated with a centrally located nucleus and granular cytoplasm, unlike white adipose cells. Conclusion: This article describes a patient with a histologically-confirmed hibernoma of the right shoulder.

동면선종

박성균(Sung-Kun Park),김형란(Hyoung-Ran Kim),홍태호(Tae-Ho Hong),이윤석(Yun-Seok Lee),김진조(Jin-Jo Kim),이근호(Keun-Ho Lee),오세정(Se-Jeong Oh),박승만(Seung-Man Park),이안희(Ahn-Hee Lee),김영하(Young-Ha Kim) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.75 No.6

Hibernoma is a rare benign tumor. It arises from brown adipose tissue, which promotes nonshivering thermogenesis. We present a case of hibernoma in the axilla and review the literature. Although it is not common, hibernoma should be considered in the differential diagnosis of lipomatous soft-tissue tumors.

척추에서 발생한 골내 동면종

권용욱(Yong-Uk Kwon),박대현(Dae-Hyun Park),이선주(Sun-Joo Lee),박하영(Ha-Young Park) 대한정형외과학회 2022 대한정형외과학회지 Vol.57 No.6

동면종은 연부조직에서 흔히 발견되는 양성종양으로 척추의 골내 동면종은 드물어 2008년부터 2019년까지 13예밖에 보고되지 않았다. 본 증례에서는 대장암 환자의 전이 병변 여부를 확인하다가 우연히 발견된 척추 골내 동면종에 대하여 생검 및 추시 자기공명영상 검사를 시행하였다. 본 저자들은 척추에 발생한 골내 동면종으로 진단된 증례를 문헌 고찰과 함께 보고하고자 한다. Although hibernomas are commonly found in soft tissues, spinal intraosseous hibernomas are extremely rare and 13 cases have been published from 2008 to 2019. While checking for metastatic lesions in a colorectal cancer patient, a spinal lesion found accidentally, thereafter biopsy and follow-up magnetic resonance imaging were performed. The authors present an intraosseous hibernoma of the spine, which is very rare.