Intraosseous hibernoma: Characterization of five cases and literature review

S. Fiona Bonar, Geoffrey Watson, Cristian Gragnaniello, Kevin Seex, John Magnussen, John Earwaker S F Bonar

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective: To describe the imaging and histopathological findings and provide an overview of a recently described and rare cause of bone sclerosis. Materials and methods: Five cases of intra-osseous hibernoma of bone that presented over the last year. The imaging and histopathology is reviewed. Results: All cases were identified in asymptomatic middle-aged to elderly adults as incidental findings with bone sclerosis in the axial skeleton. MRI showed lesions that were T1 hypointense to subcutaneous fat and hyperintense to skeletal muscle and one showed contrast enhancement. Glucose avidity was demonstrated on FDGPET in both cases tested and isotope bone scan performed in three cases showed strong positivity in two, but uptake was inconspicuous in one case. Conclusions: Intra-osseous hibernoma is a rare cause of sclerotic bone lesions, predominating in the axial skeleton of middle-aged and elderly adults. They have a non-aggressive appearance on CT and on MRI are T1 hypointense to subcutaneous fat and hyperintense to skeletal muscle. They are usually T2 hyperintense and may show peripheral contrast enhancement. They may show increased glucose avidity on FDGPET and may or may not be positive on isotope bone scans. We suspect that with ever-increasing use of a variety of imaging techniques, particularly in a setting of staging for malignant disease, more such cases will come to light. This diagnosis should be added to the differential diagnosis of sclerotic bone lesions.

LanguageEnglish
Pages939-946
Number of pages8
JournalSkeletal Radiology
Volume43
Issue number7
DOIs
Publication statusPublished - 2014
Externally publishedYes

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Lipoma
Bone and Bones
Subcutaneous Fat
Sclerosis
Skeleton
Isotopes
Skeletal Muscle
Glucose
Incidental Findings
Differential Diagnosis

Keywords

  • brown fat
  • hibernoma
  • sclerosis
  • Intraosseous

Cite this

Bonar, S. F., Watson, G., Gragnaniello, C., Seex, K., Magnussen, J., & Earwaker S F Bonar, J. (2014). Intraosseous hibernoma: Characterization of five cases and literature review. Skeletal Radiology, 43(7), 939-946. https://doi.org/10.1007/s00256-014-1868-8
Bonar, S. Fiona ; Watson, Geoffrey ; Gragnaniello, Cristian ; Seex, Kevin ; Magnussen, John ; Earwaker S F Bonar, John. / Intraosseous hibernoma : Characterization of five cases and literature review. In: Skeletal Radiology. 2014 ; Vol. 43, No. 7. pp. 939-946.
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abstract = "Objective: To describe the imaging and histopathological findings and provide an overview of a recently described and rare cause of bone sclerosis. Materials and methods: Five cases of intra-osseous hibernoma of bone that presented over the last year. The imaging and histopathology is reviewed. Results: All cases were identified in asymptomatic middle-aged to elderly adults as incidental findings with bone sclerosis in the axial skeleton. MRI showed lesions that were T1 hypointense to subcutaneous fat and hyperintense to skeletal muscle and one showed contrast enhancement. Glucose avidity was demonstrated on FDGPET in both cases tested and isotope bone scan performed in three cases showed strong positivity in two, but uptake was inconspicuous in one case. Conclusions: Intra-osseous hibernoma is a rare cause of sclerotic bone lesions, predominating in the axial skeleton of middle-aged and elderly adults. They have a non-aggressive appearance on CT and on MRI are T1 hypointense to subcutaneous fat and hyperintense to skeletal muscle. They are usually T2 hyperintense and may show peripheral contrast enhancement. They may show increased glucose avidity on FDGPET and may or may not be positive on isotope bone scans. We suspect that with ever-increasing use of a variety of imaging techniques, particularly in a setting of staging for malignant disease, more such cases will come to light. This diagnosis should be added to the differential diagnosis of sclerotic bone lesions.",
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Bonar, SF, Watson, G, Gragnaniello, C, Seex, K, Magnussen, J & Earwaker S F Bonar, J 2014, 'Intraosseous hibernoma: Characterization of five cases and literature review' Skeletal Radiology, vol. 43, no. 7, pp. 939-946. https://doi.org/10.1007/s00256-014-1868-8

Intraosseous hibernoma : Characterization of five cases and literature review. / Bonar, S. Fiona; Watson, Geoffrey; Gragnaniello, Cristian; Seex, Kevin; Magnussen, John; Earwaker S F Bonar, John.

In: Skeletal Radiology, Vol. 43, No. 7, 2014, p. 939-946.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Intraosseous hibernoma

T2 - Skeletal Radiology

AU - Bonar,S. Fiona

AU - Watson,Geoffrey

AU - Gragnaniello,Cristian

AU - Seex,Kevin

AU - Magnussen,John

AU - Earwaker S F Bonar,John

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N2 - Objective: To describe the imaging and histopathological findings and provide an overview of a recently described and rare cause of bone sclerosis. Materials and methods: Five cases of intra-osseous hibernoma of bone that presented over the last year. The imaging and histopathology is reviewed. Results: All cases were identified in asymptomatic middle-aged to elderly adults as incidental findings with bone sclerosis in the axial skeleton. MRI showed lesions that were T1 hypointense to subcutaneous fat and hyperintense to skeletal muscle and one showed contrast enhancement. Glucose avidity was demonstrated on FDGPET in both cases tested and isotope bone scan performed in three cases showed strong positivity in two, but uptake was inconspicuous in one case. Conclusions: Intra-osseous hibernoma is a rare cause of sclerotic bone lesions, predominating in the axial skeleton of middle-aged and elderly adults. They have a non-aggressive appearance on CT and on MRI are T1 hypointense to subcutaneous fat and hyperintense to skeletal muscle. They are usually T2 hyperintense and may show peripheral contrast enhancement. They may show increased glucose avidity on FDGPET and may or may not be positive on isotope bone scans. We suspect that with ever-increasing use of a variety of imaging techniques, particularly in a setting of staging for malignant disease, more such cases will come to light. This diagnosis should be added to the differential diagnosis of sclerotic bone lesions.

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