Video-assisted thoracoscopic resection clarified hibernoma diagnosis in a patient with asbestos exposure, indicating the need to recognize fat on imaging.
A man in his 60s with asbestos exposure and pleural plaques was incidentally found to have a chest wall mass on computed tomography (CT). Positron emission tomography/CT (PET/CT) demonstrated intense 18F-fluorodeoxyglucose (FDG) uptake, raising concern for malignancy, including malignant pleural mesothelioma. CT and magnetic resonance imaging (MRI), however, showed a predominantly fat-containing lesion, suggesting hibernoma. Video-assisted thoracoscopic resection was performed, and histopathology confirmed hibernoma. Recognition of macroscopic fat on CT/MRI is essential to avoid misdiagnosis of FDG-avid benign lipomatous tumors.
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Shimotsu et al. (2026) studied this question.
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