A Rare Case of Hibernoma Occasionally Identified by 18F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in a Patient with Lung Cancer

Penna, Daniele; Quartuccio, Natale; Testa, Claudio; Arena, Vincenzo; Cistaro, Angelina; Pelosi, Ettore

doi:10.7759/cureus.1124

Cited by 2 publications

(2 citation statements)

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“…On computed tomography (CT) scans, hibernomas appear as well-circumscribed, hyperdense lesions in the subcutaneous tissue sometimes deeply embedded intramuscularly, as we encountered in our case; however, this represents less than 15% of all cases. Therefore, MRI should be a part of the investigations done for any soft tissue mass that is larger than 5 cm or located deep to the fascia [1,3,4,8,9].…”

Section: Discussionmentioning

confidence: 99%

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A Diagnostic Dilemma of a Subcutaneous Hibernoma: Case Report

et al. 2020

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Objective:Rare disease Background:Subcutaneous lipomatous lesions are commonly encountered in clinical practice. Hibernoma is a rare subtype of the benign lipomatous tumor, representing 1% of all types. It poses a challenge due to the difficulty of differentiating it from atypical lipomatous lesions and liposarcomas, which may lead to possible inappropriate diagnosis and management. Case Report:We report a case of a 33-year-old male who presented with a right upper thigh swelling noticed some time prior to presentation that had started increasing in size prior to his presentation. The magnetic resonance imaging (MRI) was unable to rule out atypical lipomatous tumor and liposarcoma. An ultrasound-guided biopsy gave a diagnosis of hibernoma. The patient underwent a wide local excision, which confirmed the diagnosis of hibernoma. At the 3-year follow-up, there was no evidence of local recurrence. Conclusions:Hibernoma has been reported in the literature to be discovered incidentally by radiological imaging done for other causes. However, hibernomas raise a diagnostic challenge because in most imaging modalities they are indistinguishable from other malignant tumors. A wide local excision with negative margins is key to resolving the diagnostic dilemma that a hibernoma presents, as it will provide a definitive diagnosis differentiating it from other lipomatous lesions and prevent any future recurrence.Caution is advised when dealing with lipomatous lesions, as they often overlap with malignancy. Furthermore, an MRI should be done for any subcutaneous lesion that is larger than 5 cm or shows recent growth. A biopsy can resolve the diagnostic dilemma with caution to the hypervascularity of such tumors.

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Section: Discussionmentioning

confidence: 99%

“…Hibernomas show uptake of 8F-fluorodeoxyglucose (18F-FDG) similar to or higher than that of a liposarcoma, which makes obtaining an accurate preoperative diagnosis quite difficult. A hibernoma might even be considered a metastatic lesion in patients with a history of malignancy, or in some cases as a primary malignancy [9,12,13].…”

Section: Discussionmentioning

confidence: 99%