Hibernomas of the upper extremity: a case report and literature review

Hibernoma Around Shoulder Joint: Diagnosis and Surgical Treatment of a Rare Presentation

INTRODUCTION

Hibernomas are uncommon benign proliferations arising from the adipocytes of brown fat usually occurring over back, neck, shoulder, and thighs. It is an underreported entity often misdiagnosed as a lipoma.

CASE REPORT

We report a case of an otherwise healthy thirty-four-year-old male who presented with a painless swelling, with no preceding trauma, involving the right shoulder joint of three months duration. MRI revealed it to be a fatty intense lesion arising within the anterior fibers of the right deltoid. The tumor was removed en-masse with wide local excision through the deltopectoral route. The histopathology of the resected tumor was consistent with the diagnosis of hibernoma. The patient recovered the previously hindered movements at the shoulder joint 2 weeks post-operatively.

CONCLUSION

Hibernoma should be considered as a differential diagnosis for soft tissue tumors occurring in the above-mentioned sites. It can be completely resected surgically and no recurrences post-excision have been reported till date.

Intrascrotal hibernoma mimicking liposarcoma: A case study

Hibernoma is a rare benign lipomatous tumor derived from brown fat, which is typically found in infants. Specifically, intrascrotal hibernoma is extremely rare with only one case reported to date. We encountered the second case, which was successfully treated with surgical resection without any recurrence at 3 years.

The patient was first misdiagnosed with an intrascrotal liposarcoma preoperatively. Preoperative usefulness of imaging modalities to discriminate hibernomas and liposarcomas is limited due to lack of specific features of hibernomas with its rarity. Here, we report a case of intrascrotal hibernoma in addition to a current literature review.

•

Hibernoma is a rare benign lipomatous tumor.

•

Specifically, intrascrotal hibernoma is extremely rare with only one case reported to date.

•

Preoperative discrimination of hibernomas and lipomatous tumors is difficult.

•

A histopathological examination is needed to make a definitive diagnosis of hibernomas.

•

Immunohistochemical and FISH analyses should be performed, in cases of intrascrotal hibernoma.

Hibernoma: diagnostic and surgical considerations of a rare benign tumour

Hibernoma is a rare, benign tumour of brown fat origin. Less than 250 cases have been reported in the literature. We present a case of a 19-year-old man referred to surgical oncology for evaluation of a large soft tissue mass near the apex of his right scapula. Complete surgical excision was performed, sparing the overlying latissimus dorsi musculature. Surgical pathology revealed findings were consistent with hibernoma, grossly showing a well-encapsulated fluctuant mass measuring 21.4×14.4×5.3 cm, and histologically composed of brown fat adipocytes. The mainstay of treatment is surgical excision of the mass. Primary goals of the operation include complete removal of the mass to prevent recurrence and sparing of adjacent structures as it is a benign, non-invasive tumour. We present a case of a large chest wall hibernoma in a young adult, diagnosed on final pathology after complete surgical excision.