Hibernoma: A rare case of adipocytic tumor in head and neck
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A 30 year old man was referred for mass located in the right posterior cervical triangle of the neck. The patient had this mass since several months but it recently started to grow in a context of substantial neck pain. Clinical examination exhibited a relatively mobile, soft mass located in the supraclavicular area.

Both clinical and ultrasound examinations led to suspect a soft tissue mass, and the magnetic resonance imaging (MRI) revealed a 38 mm along the axis tumor between the elevator scapulae and the right scalene muscles. The tumor infiltrated the scalene muscles and the injection of intravenous contrast (gadolinium) reported a homogenous enhancement of an important underlying vascularization, a nodular structure of the tissue, and the presence of septa more than 2 mm.

According to the clinical features and the MRI characteristics (especially T1 sequence), liposarcoma of the neck was suspected. The fine needle aspiration biopsy was made but non-contributory. Thus, a surgical procedure was made to completely excise the mass and the macroscopic examination revealed an encapsulated taned-brown polylobulated tumor. The immediate post-operative follow-up was unremarkable. The 4-years follow-up was unremarkable and the patient had no recurrence.

Hibernoma is a rare benign tumor that can mimic malignant lesion of the soft tissue such as liposarcoma. Unusual presentation of hibernoma of the posterior cervical triangle characterized by both severe pain and rapid growth is reported. The biopsy and the surgery procedure correspond to the gold standard approaches for the final diagnosis, the exclusion of liposarcoma, and to select the appropriate treatment.

Source: https://bmcearnosethroatdisord.biomedcentral.com/articles/10.1186/s12901-017-0046-8
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