Intraosseous hibernoma is a rare benign bone tumor, with only 4 cases reported in English literature.
Case report: In this report, we describe a 42-year-old man with no past medical history and right chest pain. Imaging studies showed an osteolytic lesion with fat attenuation lesion in the right fourth rib. The lesion was completely resected and microscopic study showed mildly thickened bone trabeculae and multivacuolated brown fat cells replacing the normal white fat and hematopoietic elements. The diagnostic of intraosseous hibernoma was made.
Conclusion: Although it is rare, hibernoma should be included in the differential diagnosis of lipomatous tumors.