Laryngeal Hibernoma

Abstract

Objective: Recognize hibernoma as an uncommon, benign tumor composed of brown adipose tissue that can occur in the head and neck. Learn the unique radiographic features of this rare tumor, and understand the principles of treatment. Method: A systematic review of the English literature was conducted. In addition, we present a series of 2 laryngeal hibernomas treated with transoral laser microsurgical resection at a tertiary referral center over a period of 18 years. Results: Nineteen cases of hibernoma in the cervicofacial region have been described in the literature. This includes only 2 cases of laryngeal hibernoma ever reported. We present a series of 2 laryngeal hibernomas encountered at our institution. In each case, preoperative imaging demonstrated a well-circumscribed neoplasm with fat density compatible with lipoma, but internal heterogeneity and vascularity seen in the context of liposarcoma. Transoral laser microsurgical resection was successfully completed in each case. Grossly, the tumors had the fatty appearance of a lipoma, however final pathology revealed myxoid hibernoma. Both patients healed well with normal speech and swallowing postoperatively. Conclusion: Hibernoma is a tumor composed of brown adipose tissue. There have been only 2 cases of para-glottic hibernoma reported to date. We report 2 additional cases of laryngeal hibernoma. In our experience, complete resection via transoral laser microsurgery is a safe and effective treatment modality with very little associated morbidity.