Hibernoma: MRI features in eight consecutive cases

Lee, J.C.; Gupta, A.; Saifuddin, A.; Flanagan, A.; Skinner, J.A.; Briggs, T.W.R.; Cannon, S.R.

doi:10.1016/j.crad.2006.05.018

« Previous Next »Clinical Radiology
Volume 61, Issue 12 , Pages 1029-1034, December 2006

Hibernoma: MRI features in eight consecutive cases

J.C. Lee
- Departments of Radiology
A. Gupta
- Orthopaedic Oncology
A. Saifuddin
- The London Bone and Soft Tissue Tumour Service, London, UK
- The Institute of Orthopaedics and Musculoskeletal Sciences, University College, London, UK
- Guarantor and correspondent: A. Saifuddin, The Department of Radiology, The Royal National Orthopaedic Hospital Trust, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK. Tel.: +44 020 8909 5443; fax: +44 020 8909 5281.
A. Flanagan
- The London Bone and Soft Tissue Tumour Service, London, UK
- The Institute of Orthopaedics and Musculoskeletal Sciences, University College, London, UK
- Histpathology, The Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex HA7 4LP, UK
J.A. Skinner
- Orthopaedic Oncology
- The London Bone and Soft Tissue Tumour Service, London, UK
- The Institute of Orthopaedics and Musculoskeletal Sciences, University College, London, UK
T.W.R. Briggs
- Orthopaedic Oncology
- The London Bone and Soft Tissue Tumour Service, London, UK
- The Institute of Orthopaedics and Musculoskeletal Sciences, University College, London, UK
S.R. Cannon
- Orthopaedic Oncology
- The London Bone and Soft Tissue Tumour Service, London, UK
- The Institute of Orthopaedics and Musculoskeletal Sciences, University College, London, UK

Received 6 March 2006; received in revised form 8 May 2006; accepted 12 May 2006.

Aim

To describe the preoperative magnetic resonance imaging findings of eight histologically-proven cases of hibernoma.

Materials and methods

The site, size, and signal characteristics of eight consecutive hibernomas were retrospectively assessed on T1-weighted spin-echo and short T1 inversion recovery (STIR)/fat-saturated T2-weighted fast spin echo magnetic resonance images. Four patients also had gadolinium-enhanced fat-saturated T1-weighted spin echo imaging. Patient age and sex, and duration of symptoms were recorded.

Results

Three female and five male patients with an average age 36 years (range 16–53 years) were included. Seven lesions occurred in the thigh, four in the anterior compartment and three in the posterior compartment. One lesion occurred superficial to the scapula. All cases demonstrated common magnetic resonance imaging findings of a well-defined, heterogeneous mass, slightly or clearly hypo-intense to subcutaneous fat on T1-weighted spin-echo images, with prominent thin low signal bands throughout the tumour. The lesions failed to fully suppress on STIR or fat-saturated T2-weighted images. Only one of the four contrast-enhanced studies demonstrated increased vascularity in the tumour.

Conclusion

The MRI findings of a lesion that is diffusely slightly hypointense to surrounding subcutaneous fat, should prompt the operator to consider hibernoma in the differential diagnosis.