Skeletal Radiology

, Volume 40, Issue 5, pp 641–645 | Cite as

Intraosseous hibernoma

  • Rajendra Kumar
  • Michael T. Deaver
  • Bogdan A. Czerniak
  • John E. Madewell
Case Report


We describe the imaging and pathological features of a rare case of sacral hibernoma that was discovered incidentally in a patient with low back pain. The benign-appearing, small intraosseous lesion in the sacrum was sclerotic on CT. MRI revealed that the lesion was heterogeneously hyperintense on T1W (lower in intensity than subcutaneous fat) and heterogeneously hypointense on fat-saturated T2W and STIR images. It showed mild heterogeneous enhancement on the post-contrast fat-saturated T1 MR images due to increased vascularity. A biopsy of the lesion was performed. The biopsy specimen demonstrated multivacuolated cells with immunohistochemical features of brown adipose tissue consistent with hibernoma.


Hibernoma Intraosseous fatty tumor Benign bone tumor 


  1. 1.
    Merkel H. On a pseudolipoma of the breast. Beitr Pathol Anat. 1906;39:152–7.Google Scholar
  2. 2.
    Gery L. In discussion of MF Bonnel’s paper. Bull Mem Soc Anat (Paris). 1914;89:111–2.Google Scholar
  3. 3.
    Furlong MA, Fanburg-Smith JC, Miettinen M. The morphologic spectrum of hibernoma: a clinicopathologic study of 170 cases. Am J Surg Pathol. 2001;25(6):809–14.PubMedCrossRefGoogle Scholar
  4. 4.
    Reyes AR IR, Wilson JD, Desai HS. Intraosseous hibernoma of the femur: an unusual case with a review of the literature (poster #20). College of American Pathologists 2008; 132:3.Google Scholar
  5. 5.
    Himms-Hagen J. Brown adipose tissue thermogenesis: interdisciplinary studies. FASEB J. 1990;4(11):2890–8.PubMedGoogle Scholar
  6. 6.
    Ito T, Tanuma Y, Yamada M, Yamamoto M. Morphological studies on brown adipose tissue in the bat and in humans of various ages. Arch Histol Cytol. 1991;54(1):1–39.PubMedCrossRefGoogle Scholar
  7. 7.
    Kransdorf MJ, Murphey MD. Lipomatous tumors. In: Imaging of soft tissue tumors. Philadelphia: Lippincott Williams & Wilkins. 1997;77–83.Google Scholar
  8. 8.
    Eyzaguirre E, Liqiang W, Karla GM, Rajendra K, Alberto A, Gatalica Z. Intraosseous lipoma. A clinical, radiologic, and pathologic study of 5 cases. Ann Diagn Pathol. 2007;11(5):320–5.PubMedCrossRefGoogle Scholar
  9. 9.
    Nedergaard J, Bengtsson T, Cannon B. Unexpected evidence for active brown adipose tissue in adult humans. Am J Physiol Endocrinol Metab. 2007;293(2):E444–E452.PubMedCrossRefGoogle Scholar
  10. 10.
    Thorns C, Schardt C, Katenkamp D, Kahler C, Merz H, Feller AC. Hibernoma-like brown fat in the bone marrow: report of a unique case. Virchows Arch. 2008;452(3):343–5.PubMedCrossRefGoogle Scholar
  11. 11.
    Mugel T, Ghossain MA, Guinet C, Buy J, Bethoux J, Texier P, et al. MR and CT findings in a case of hibernoma of the thigh extending into the pelvis. Eur Radiol. 1998;8(3):476–8.PubMedCrossRefGoogle Scholar
  12. 12.
    Dursun M, Agayev A, Bakir B, Ozger H, Eralp L, Sirvanci M, et al. CT and MR characteristics of hibernoma: six cases. Clin Imaging. 2008;32(1):42–7.PubMedCrossRefGoogle Scholar
  13. 13.
    Anderson SE, Schwab C, Stauffer E, Banic A, Steinbach LS. Hibernoma: imaging characteristics of a rare benign soft tissue tumor. Skeletal Radiol. 2001;30(10):590–5.PubMedCrossRefGoogle Scholar
  14. 14.
    Lee JC, Gupta A, Saifuddin A, Flanagan A, Skinner JA, Briggs TW, et al. Hibernoma: MRI features in eight consecutive cases. Clin Radiol. 2006;61(12):1029–34.PubMedCrossRefGoogle Scholar
  15. 15.
    Peer S, Kuhberger R, Dessl A, Judmaier W. MR imaging findings in hibernoma. Skeletal Radiol. 1997;26(8):507.PubMedCrossRefGoogle Scholar
  16. 16.
    Subramaniam RM, Clayton AC, Karantanis D, Collins DA. Hibernoma: 18F FDG PET/CT imaging. J Thorac Oncol. 2007;2(6):569–70.PubMedCrossRefGoogle Scholar
  17. 17.
    Gaffney EF, Hargreaves HK, Semple E, Vellios F. Hibernoma: distinctive light and electron microscopic features and relationship to brown adipose tissue. Hum Pathol. 1983;14(8):677–87.PubMedCrossRefGoogle Scholar
  18. 18.
    Jambhekar NA, Rekhi B, Thorat K, Dikshit R, Agrawal M, Puri A. Revisiting chordoma with brachyury, a “new age” marker: analysis of a validation study on 51 cases. Arch Pathol Lab Med. 2010;134(8):1181–1187.PubMedGoogle Scholar
  19. 19.
    Lowry WS, Halmos PB. Malignant tumor of brown fat in patient with Turner’s syndrome. Br Med J. 1967;4(5581):720–1.PubMedCrossRefGoogle Scholar

Copyright information

© ISS 2011

Authors and Affiliations

  • Rajendra Kumar
    • 1
  • Michael T. Deaver
    • 2
  • Bogdan A. Czerniak
    • 2
  • John E. Madewell
    • 1
  1. 1.Department of Diagnostic RadiologyUniversity of Texas MD Anderson Cancer CenterHoustonUSA
  2. 2.Department of PathologyUniversity of Texas MD Anderson Cancer CenterHoustonUSA

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