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Samargandi R, Le Nail LR, de Pinieux G, Tallegas M, Miquelestorena-Standley E. Intraosseous Hibernoma: A Rare Entity in Orthopedics With Peculiar Radiological Features. Cureus 2023; 15:e39883. [PMID: 37273679 PMCID: PMC10237511 DOI: 10.7759/cureus.39883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2023] [Indexed: 06/06/2023] Open
Abstract
Intraosseous hibernoma is a rare benign bone tumor derived from brown fat. It is typically found in the axial skeleton and is more commonly observed in women. It can manifest as a painful lesion or may be incidentally discovered. Intraosseous hibernoma often presents as a sclerotic lesion, although it can also manifest as a lytic lesion. Due to its varied radiographic appearance, it should be considered in the differential diagnosis of bone lesions as it can mimic metastatic lesions as well as other sclerotic and lytic bone lesions. Therefore, obtaining a biopsy of the lesion is crucial for an accurate diagnosis. In this report, we present the clinical, radiological, and histopathological findings of two cases of intraosseous hibernoma and provide a concise overview based on a review of the literature.
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Affiliation(s)
- Ramy Samargandi
- Service d'Orthopédie et Traumatologie, Centre Hospitalier Régional Universitaire (CHRU) de Tours, Tours, FRA
- Orthopedic Surgery Department, Faculty of Medicine, University of Jeddah, Jeddah, SAU
| | - Louis-Romée Le Nail
- Service d'Orthopédie et Traumatologie, Centre Hospitalier Régional Universitaire (CHRU) de Tours, Tours, FRA
| | - Gonzague de Pinieux
- Service d'Anatomie et Cytologie Pathologique, Centre Hospitalier Régional Universitaire (CHRU) de Tours, Tours, FRA
| | - Matthias Tallegas
- Service d'Anatomie et Cytologie Pathologique, Centre Hospitalier Régional Universitaire (CHRU) de Tours, Tours, FRA
- Service Biologie Moléculaire, Centre Hospitalier Régional Universitaire (CHRU) de Tours, Tours, FRA
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Gangahar CN, Dehner CA, Wang DP, Amini B, Hillen T, O'Conor C, Jennings SN, Byrnes K, Montgomery EA, Czerniak BA, Bridge JA, Schroeder MC, Jennings JW, Wang WL, Chrisinger JSA. Intraosseous hibernoma: clinicopathologic and imaging analysis of 18 cases. Histopathology 2023. [PMID: 37099409 DOI: 10.1111/his.14928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 04/27/2023]
Abstract
AIMS Intraosseous hibernomas are rarely reported tumours with brown adipocytic differentiation of unknown aetiology, with only 38 cases documented in the literature. We sought to further characterise the clinicopathologic, imaging and molecular features of these tumours. METHODS AND RESULT Eighteen cases were identified occurring in eight females and 10 males (median age = 65 years, range = 7-75). Imaging indication was cancer surveillance/staging in 11 patients and clinical concern for a metastasis was raised in 13 patients. The innominate bone (7), sacrum (5), mobile spine (4), humerus (1) and femur (1) were involved. Median tumour size was 1.5 cm (range = 0.8-3.8). Tumours were sclerotic (11), mixed sclerotic and lytic (4) or occult (1). Microscopically, tumours were composed of large polygonal cells with distinct cell membranes, finely vacuolated cytoplasm, central or paracentral small bland nuclei with prominent scalloping. Growth around trabecular bone was observed. Tumour cells were immunoreactive for S100 protein (15/15) and adipophilin (5/5), while negative for keratin AE1/AE3(/PCK26) (0/14) and brachyury (0/2). Chromosomal microarray analysis, performed on four cases, did not show clinically significant copy number variation across the genome or on 11q, the site of AIP and MEN1. CONCLUSION Analysis of 18 cases of intraosseous hibernoma, to our knowledge, the largest series to date, revealed that these tumours are most often detected in the spine and pelvis of older adults. Tumours were generally small, sclerotic and frequently found incidentally and can raise concern for metastasis. Whether or not these tumours are related to soft tissue hibernomas is uncertain.
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Affiliation(s)
- Chiraag N Gangahar
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO, USA
| | - Carina A Dehner
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO, USA
| | - David P Wang
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Behrang Amini
- Department of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Travis Hillen
- Musculoskeletal Section, Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - Christopher O'Conor
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Kathleen Byrnes
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO, USA
| | | | - Bogdan A Czerniak
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Julia A Bridge
- Propath, Dallas, TX, USA
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Molly C Schroeder
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO, USA
| | - Jack W Jennings
- Musculoskeletal Section, Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - Wei-Lien Wang
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - John S A Chrisinger
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO, USA
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