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Journal of Radiological Review 2022 September;9(3):150-4

DOI: 10.23736/S2723-9284.22.00199-3

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Hibernoma of two contiguous vertebrae: uniqueness of a lesion already rare in itself

Donato MASTRANTUONO ¹ ✉, Domenico MARTORANO ¹, Guido REGIS ¹, Federica ARABIA ¹, Alessandra LINARI ², Federica SANTORO ²

¹ Division of Radiology, Department of Diagnostic Imaging and Radiotherapy, C.T.O. Hospital, Città della Salute e della Scienza, Turin, Italy; ² Department of Laboratory Medicine, Institute of Anatomy and Pathologic Histology, Città della Salute e della Scienza, Turin, Italy

The painful symptoms associated with MRI findings of a focal somatic lesion in two contiguous vertebrae, T12 and L1, in a patient with a history of breast cancer, rightly worried the oncological orthopedists of our hospital about the possibility of a metastasis. After a multidisciplinary approach and a clinical sharing with the care team of Bone Sarcomas and Soft Tissues, our involvement as Interventional Radiology Unit was requested. Our medical team, based at the C.T.O. Hospital of Turin, deals, among other things, with CT-guided bone biopsies, essential procedure to define the diagnosis and the therapeutic path to perform in case of primary and secondary bone tumors of unknown origin. A careful study of the imaging CT and MR anticipated the procedure. The two vertebral lesions, localized in the soma of T12 and L1 respectively, associated with a sclerotic CT appearance, were both biopsied in the same session and the samples were sent to the pertinent Pathological Anatomy Unit. The biopsy results showed no signs of metastases, but both lesions were diagnosed as intraosseous hibernoma, considered in the literature, an unusual histologically benign tumor. The intraosseous hibernoma, did not require any treatment, neither traditional surgery nor percutaneous, but it was decided to subject the patient to MRI controls over time and eventually perform a radiofrequency ablation in case of persistence or worsening of pain.

KEY WORDS: Lipoma; Magnetic resonance imaging; Adipose tissue; Neoplasms