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Skeletal Radiol. 2016 Nov;45(11):1565-9. doi: 10.1007/s00256-016-2460-1. Epub 2016 Sep 6.

Intraosseous hibernoma: a rare adipocytic bone tumour.

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Department of Radiology, Nuffield Orthopaedic Centre, Oxford, UK.
Orthopaedic Surgery, Nuffield Orthopaedic Centre, Oxford, UK.
Department of Pathology, Nuffield Orthopaedic Centre, Oxford, UK.
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Oxford, OX3 7HE, UK.


Hibernoma is a benign adipose tumour that contains foetal brown fat cells. We report a case of hibernoma arising in the left ischium of a 65-year-old female with a past history of ovarian carcinoma. The patient presented with a relatively short history of left sacral/hip pain. Radiologically, the lesion, which was large (5 cm) and sclerotic, had been stable for a number of years. Histologically, it was composed mainly of plump cells with foamy, multivacuolated cytoplasm. These cells showed no reaction for epithelial, melanoma or leucocyte markers but expressed FABP4/aP2 and S100, indicating that they were brown fat cells. There was no mitotic activity or nuclear pleomorphism and the lesion was diagnosed as a benign intraosseous hibernoma (IOH). IOH is a recently identified benign adipocytic lesion that presents typically as a sclerotic bone lesion. It has characteristic morphological and immunophenotypic features and should be regarded as a discrete primary bone tumour that needs to be distinguished from metastatic carcinoma/melanoma, chondrosarcoma and metabolic storage diseases containing numerous foamy macrophages.


Adipose tissue; Bone tumour; Hibernoma; Pelvis

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