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Deep-seated huge hibernoma of soft tissue: a rare differential diagnosis of atypical lipomatous tumor/well differentiated liposarcoma.
[well-differentiated liposarcoma]
Hibernoma
is
a
rare
benign
fat-forming
soft
tissue
tumor
that
differentiates
similar
to
brown
fat
,
hence
an
origin
from
remnants
of
fetal
brown
adipose
tissue
has
been
proposed
.
Mainly
young
adults
are
affected
,
usually
without
significant
clinical
symptoms
.
We
report
on
four
patients
with
hibernomas
,
who
were
treated
at
our
hospital
during
the
last
10
years
.
The
clinicopathologic
and
immunohistochemical
features
are
presented
and
treatment
and
follow-up
data
discussed
.
Patients
were
2
women
and
2
men
aged
21
-
67
years
(
mean
:
45
yrs
)
who
presented
with
a
slowly
growing
,
painless
mass
.
The
anatomic
location
was
the
thigh
,
upper
arm
,
lateral
thoracic
wall
and
paravertebral
soft
tissue
.
Two
of
them
were
diagnosed
preoperatively
through
a
percutaneous
core
needle
biopsy
and
the
other
two
underwent
surgery
because
of
high
clinical
and
radiological
suspicion
of
liposarcoma
.
The
tumor
's
size
ranged
from
7
cm
to
15
.
5
cm
(
mean
:
11
cm
)
.
All
were
deep
-seated
subfascial
intramuscular
masses
.
Histologically
,
all
four
tumors
were
of
the
typical
variant
.
All
patients
underwent
a
R
0
-
surgical
resection
of
the
tumor
and
they
were
recurrence-free
at
last
follow-up
(
mean
:
47
months
;
range
:
25
-
87
)
.
Hibernoma
may
present
as
huge
deep
intramuscular
soft
tissue
mass
in
adults
,
closely
mimicking
well
differentiated
liposarcoma
and
should
be
considered
in
the
differential
diagnosis
of
fatty
soft
tissue
tumors
in
any
location
.
Surgical
excision
is
the
treatment
of
choice
.
The
tumor
has
no
malignant
or
recurrence
potential
.
Diseases
Validation
Diseases presenting
"fetal brown adipose tissue"
symptom
well-differentiated liposarcoma
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