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一名老年患者大腿后部罕见的冬眠瘤病例:手术病例报告

A rare case of hibernoma in the posterior thigh of an elderly patient: A surgical case report.

作者信息

Bouhouche Mohammed, Lamris Mohamed Amine, Bachkira El Mehdi, Rafaoui Abderrahim, Rahmi Mohamed, Rafai Mohamed

机构信息

Resident in Orthopedics and Traumatology Surgery at the 32 pavilion of CHU Ibn Rochd of Casablanca, Morocco.

Resident in Orthopedics and Traumatology Surgery at the 32 pavilion of CHU Ibn Rochd of Casablanca, Morocco.

出版信息

Int J Surg Case Rep. 2024 Sep;122:110067. doi: 10.1016/j.ijscr.2024.110067. Epub 2024 Jul 20.

Abstract

INTRODUCTION AND IMPORTANCE

Hibernoma is a rare benign adipose tumor that arises from brown fat. Often misdiagnosed as liposarcoma, hibernomas require biopsy and histopathological examination for accurate diagnosis. This case report presents an unusual instance of hibernoma located in the posterior thigh of an elderly patient, emphasizing the diagnostic challenges and surgical management involved.

CASE PRESENTATION

We report the case of Mrs. F.D., a 70-year-old woman with a history of ovarian cyst surgery 17 years prior, who presented with a mass in the posterior left thigh. The mass had been developing over two years and was hard, painless, and measured 7 × 12 cm. Initial imaging suggested liposarcoma; however, an MRI revealed a 9 × 19 cm mass with heterogeneous tissue characteristics. A surgical biopsy confirmed the diagnosis of hibernoma. The tumor was excised completely, and histological examination showed typical features of hibernoma.

CLINICAL DISCUSSION

Hibernomas, although rare, should be considered in the differential diagnosis of soft tissue masses. Imaging techniques such as MRI are essential, but definitive diagnosis relies on histopathology. Surgical excision is the treatment of choice, requiring meticulous technique to manage the hypervascular nature of the tumor.

CONCLUSION

This case underscores the importance of considering hibernoma in differential diagnoses and highlights the role of biopsy for accurate diagnosis. Complete surgical excision is crucial to prevent recurrence. Further research is needed to better understand the pathogenesis and optimal management of hibernomas.

摘要

引言与重要性

冬眠瘤是一种罕见的起源于棕色脂肪的良性脂肪肿瘤。冬眠瘤常被误诊为脂肪肉瘤,需要进行活检和组织病理学检查以准确诊断。本病例报告展示了一例位于老年患者大腿后部的不寻常冬眠瘤病例,强调了其中涉及的诊断挑战和手术处理。

病例介绍

我们报告了F.D.夫人的病例,她是一名70岁女性,17年前有卵巢囊肿手术史,此次因左大腿后部出现肿块前来就诊。该肿块已持续发展两年,质地坚硬、无痛,大小为7×12厘米。初步影像学检查提示为脂肪肉瘤;然而,磁共振成像(MRI)显示一个9×19厘米的肿块,具有异质性组织特征。手术活检确诊为冬眠瘤。肿瘤被完整切除,组织学检查显示出冬眠瘤的典型特征。

临床讨论

冬眠瘤虽然罕见,但在软组织肿块的鉴别诊断中应予以考虑。MRI等影像学技术至关重要,但明确诊断依赖于组织病理学。手术切除是首选治疗方法,需要精细的技术来处理肿瘤的高血管特性。

结论

本病例强调了在鉴别诊断中考虑冬眠瘤的重要性,并突出了活检对于准确诊断的作用。完整的手术切除对于预防复发至关重要。需要进一步研究以更好地了解冬眠瘤的发病机制和最佳治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1426/11320421/fd2e728b53ea/gr1.jpg

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