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Differential Diagnosis of Hibernoma: (continued)

Hibernoma vs Liposarcoma: Some hibernomas have lipoblast-like cells that may lead to a mistaken diagnosis of atypical lipomatous tumor/well-differentiated liposarcoma (ATL/WDL); however, hibernomas lack the MDM2 and CDK4 amplification.

Variants of high-grade myxoid liposarcoma as well as ATL/WDL with hibernoma-like cells have been documented. The diagnosis can be sorted out with molecular analysis (DDIT3 fusions in case of myxoid liposarcomas and MDM2 amplification for ALT/WDL). Hibernomas lack these molecular alterations and instead show genomic rearrangements of 11q13 region resulting in codeletion of tumor suppressor genes MEN1 and AIP.

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