Article
Hibernoma – a rare case of nerve compression
Hibermone – ein seltener Nervenkompressionsfall
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Published: | April 11, 2007 |
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Objective: Hibernoma arises from residuals of fetal brown adipose tissue. Slow growing it can cause compression of the neighbouring structures as muscles or nerves. The authors describe a case of hibernoma with compression of the sciatic nerve.
Methods: A thirty-six-year-old male complains of pain and paraesthesia of his left thigh for almost one year. In addition, he notices a swelling of his femur. Motor function is not affected. An electrophysiological study does not show any signs of denervation of the tibial anterior, peroneal or triceps surae muscles, but SEP of the left peroneal nerve reveales a deceleration of 6 m/sec compared to the right side. MRI showes a mass lesion of 20x10 cm, which is located under the biceps femoris muscle. The tumor seems to consist of some liquid and adipose tissue. The patient undergoes pre-surgery staging, but no metastases or any other tumors are found.
Results: The tumor causes a compression of the sciatic nerve and displaces it downwards. The mass lesion in its pseudocapsule was resected in toto and nerval structures released. The histopathological study revealed a hibernoma. Radiatio and chemotherapy were therefore not necessary. The postoperative course was uneventful and the patient discharged on the 8th postoperative day with light paraesthesia of the dorsal part of his leg and without motor weakness and numbness in the sciatic territory.
Conclusions: The Hibernoma is a rare benign tumor. The most common localizations are thigh, back, arm or chest. Its total resection is necessary before malignant transformation occurs.