Chitoku S, Kawai S, Watabe Y, Nishitani M, Fujimoto K, Otsuka H, Fushimi H, Kotoh K, Fuji T
Department of Neurosurgery, Osaka Prefectural Hospital, Japan.
Surg Neurol. 1998 May;49(5):509-12; discussion 512-3. doi: 10.1016/s0090-3019(97)00304-2.
Hibernoma is a rare, benign tumor arising from vestigial remnants of brown adipose tissue. It usually affects muscle and subcutaneous tissue and is asymptomatic and slow growing.
A review of the worldwide literature contains about 110 cases of hibernomas. However, only two cases (including our case) of hibernoma located in the intradural spine have been reported. We present an extremely rare case of intradural extramedullary spinal hibernoma and summarize the magnetic resonance imaging (MRI) findings of the lesion.
A 35-year-old woman suffered from motor weakness and numbness of the left upper extremity. Cervical spinal MRI revealed an intradural extramedullary mass at C7. She underwent surgery via the posterior approach and the lesion was completely removed. Histopathologic examination showed multivacuolated cells with centrally placed nuclei, and the diagnosis of hibernoma was made.
Because the CT and MRI findings of hibernoma are almost same as those of other lipomatous tumors, a surgical specimen of this tumor is necessary to establish the correct diagnosis. Early diagnosis and total resection are necessary as some cases showed malignant features or rapid growth. Etiologically, the tumor may have developed by the ectopic growth or migration of adipose tissue.
冬眠瘤是一种罕见的良性肿瘤,由棕色脂肪组织的残余遗迹产生。它通常累及肌肉和皮下组织,无症状且生长缓慢。
对全球文献的回顾发现约有110例冬眠瘤病例。然而,仅有两例(包括我们的病例)位于硬脊膜内脊柱的冬眠瘤被报道。我们报告一例极其罕见的硬脊膜内髓外脊柱冬眠瘤病例,并总结该病变的磁共振成像(MRI)表现。
一名35岁女性出现左上肢运动无力和麻木。颈椎MRI显示C7水平有一硬脊膜内髓外肿块。她接受了后路手术,病变被完全切除。组织病理学检查显示有多泡状细胞,细胞核位于中央,诊断为冬眠瘤。
由于冬眠瘤的CT和MRI表现与其他脂肪瘤性肿瘤几乎相同,因此需要手术标本才能做出正确诊断。由于一些病例表现出恶性特征或生长迅速,早期诊断和完整切除很有必要。从病因学角度来看,该肿瘤可能是由脂肪组织的异位生长或迁移形成的。