Surgical Management of Residual or Recurred Hibernoma of the Neck

ABSTRACT

A 16-year-old girl was incidentally found to have a mediastinal lipogenic mass, which was confirmed as a hibernoma on biopsy. Mediastinal mass excision with full sternotomy was performed, and follow-up chest computed tomography at postoperative 1 year revealed a residual or recurred mass at the left neck (level VI). Consequently, left level-VI neck dissection was performed, and the biopsy also confirmed hibernoma. During neck dissection, an electromyography tube was used to monitor the recurrent laryngeal nerve, and complete removal was achieved without damage to the vagus nerve, carotid vessels, or thyroid gland. When managing cervical lipogenic tumors, clinical suspicion is necessary, followed by radiological and pathological evaluations to differentiate malignancies. If a hibernoma is suspected, en bloc resection of the tumor is crucial to prevent hemorrhage and recurrence. Cervical hibernoma can cause symptoms such as dysphagia, weight loss, and exertional dyspnea owing to its mass effect. Surgeons should be cautious during tumor removal to protect the recurrent laryngeal nerve. We successfully removed the residual or recurred hibernoma in the neck without complications.