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Beitragstitel Hibernoma
Beitragscode P62
  1. Jan Danek Vortragender
  2. Carlo Theus-Steinmann Articon Spezialpraxis für Gelenkchirurgie
  3. Bruno Fuchs Luzerner Kantonsspital & Swiss Sarcoma Network
Präsentationsform Poster
  • A07 - Spezialgebiet 3 | Tumore
Abstract Objective
Hibernoma or fetal fat cell lipoma is a rare benign adipocytic tumor consisting of brown fat and occurs predominantly in young adults with a mean age of 40 years. It is most commonly located in the subcutis of the thigh, followed by trunk, upper extremity, head and neck. Intra-muscular (up to 20%) and rare cases of intraosseous location have also been described. Because of an abundance of mitochondria and higher vascularity in comparison to a lipoma they have a red-brown gross appearance and may become quite large.

We present five cases of symptomatic hibernoma in four females and one male with a mean age of 52 years. In three patients, the hibernoma was located intramuscularly: One in the right parascapular region with a maximal tumor dimension of 10cm, one in the left subdeltoid (11cm) and one in the left gluteal region (13cm). In two patients the hibernoma was intraosseous, one in the left sacral ala (1.5cm) and one in the left medial femoral condyle (3cm) respectively. All lesions were histologically proven by imaging guided core needle biopsy, showing typical brown fat cells with mitochondria-rich, eosinophilic, granular cytoplasm.

The intraosseous hibernoma of the left knee could be managed conservatively with follow-up of the lesion due to minor symptoms and no risk of impending fracture. The other 4 hibernomas were surgically treated. For the intraosseous sacral ala lesion a microsurgical decompression was performed, and the other 3 intramuscular located hibernomas were excised in toto. The postoperative course in all patients was uneventful.

Hibernoma has to be considered as a differential diagnosis for adipocytic tumors and due to their growth or sometimes intraosseous location they can become symptomatic. Surgical excision is the treatment of choice and it has no significant potential for local recurrence.