From the Guidelines
Fat necrosis is a condition where fat cells die and release their contents, causing inflammation and forming a firm lump in fatty tissue, often associated with trauma, surgery, or radiation to fatty areas. This condition can occur in various parts of the body, including the breast, buttocks, or thighs, and may mimic cancer on physical examination and imaging due to the formation of a hard, sometimes painful mass [/1]. The dead fat cells trigger an inflammatory response as the body attempts to clean up the damaged tissue, resulting in a range of symptoms and signs, including skin retraction or discoloration, and calcifications visible on imaging studies like mammograms. Key characteristics of fat necrosis include:
- Benign condition with no increased risk of cancer
- Often resolves on its own without specific treatment
- May require biopsy to rule out malignancy in persistent or concerning lesions
- Can be difficult to distinguish from cancerous tumors without appropriate testing It is essential to evaluate fat necrosis properly to ensure it is not mistaken for a malignant condition, given its potential to mimic cancer in clinical presentation and imaging [/1].
From the Research
Definition and Causes of Fat Necrosis
- Fat necrosis is a condition where fatty tissue dies due to various causes, including enzymatic degradation by lipases 2, 3.
- It can occur in any area rich in fatty tissue, such as the breast, subcutaneous tissue, joints, and bone marrow 2, 3.
- The precise mechanism of fat necrosis is not fully understood, but it is thought to involve the action of pancreatic lipase and colipase, which can escape from the pancreas during disease or trauma 2.
Clinical Presentation and Diagnosis
- Fat necrosis can present with a range of symptoms, including skin lesions, polyarthritis, and osteolytic defects, depending on the location and extent of the necrosis 2.
- Diagnosis can be made through imaging studies, such as ultrasonography, and histopathological examination of biopsy specimens 3, 4.
- Fat necrosis can be confused with other conditions, such as cancer, and accurate diagnosis requires careful consideration of clinical history and imaging findings 3, 5.
Classification and Treatment
- There is no uniform definition of fat necrosis, but it can be defined as a palpable, discrete, and persistent subcutaneous firmness found postoperatively 4.
- A classification system for fat necrosis has been proposed, which can help guide clinical decision-making 4.
- Treatment of fat necrosis depends on the underlying cause and may involve surgical excision, enzyme inhibition, or other supportive measures 6.