I have found one in a very flat TV, that I wanted to repair and was intrigued, too.
Their advantage is of course the huge surface area, that can radiate heat very well. But the thermal conductivity on the other hand is horrible.
So [speculation] they are probably good when they are about as large as the chip they are supposed to cool, but it makes little sense to make them larger. [/speculation]
I guess that that is reason why they used it in the flat TV, there was very little space and the ceramic heat sink gets a lot of surface area in there.
The interfacing surface was very rough, so a gap-filling thermal interface material has to be used.