Fat necrosis

A condition involving the death of fat tissue

Fat necrosis is a condition characterized by the death of adipose tissue (fat cells) in the body. This process can occur in various parts of the body and is often associated with trauma, surgery, or inflammation. Fat necrosis is most commonly observed in the breast, pancreas, and subcutaneous tissue.

Pathophysiology

Fat necrosis occurs when fat cells are damaged, leading to the release of their contents, including triglycerides and lipase enzymes. The lipase enzymes break down the triglycerides into free fatty acids and glycerol. These free fatty acids can then bind with calcium ions to form calcium soaps, a process known as saponification. This results in the formation of firm, chalky deposits in the affected tissue.

Causes

Fat necrosis can be caused by a variety of factors, including:

• Trauma: Physical injury to fatty tissue can lead to fat necrosis. This is commonly seen in the breast following blunt trauma or surgical procedures.
• Surgery: Surgical interventions, particularly those involving the breast or abdomen, can result in fat necrosis due to tissue manipulation and disruption of blood supply.
• Pancreatitis: Inflammation of the pancreas can lead to fat necrosis in the surrounding tissue due to the release of pancreatic enzymes.
• Radiation therapy: Exposure to radiation can damage fat cells, leading to necrosis.

Clinical Presentation

The clinical presentation of fat necrosis varies depending on the location and extent of the necrosis. Common symptoms include:

• Breast: In the breast, fat necrosis may present as a painless, firm lump. It can sometimes mimic the appearance of breast cancer on imaging studies, necessitating further investigation.
• Pancreas: In the context of pancreatitis, fat necrosis may contribute to abdominal pain and systemic inflammation.
• Subcutaneous tissue: Fat necrosis in the subcutaneous tissue may present as firm nodules or masses under the skin.

Diagnosis

Diagnosis of fat necrosis typically involves a combination of clinical examination, imaging studies, and sometimes biopsy. Imaging techniques such as mammography, ultrasound, and CT scan can help differentiate fat necrosis from other conditions. A biopsy may be performed to confirm the diagnosis and rule out malignancy.

Treatment

Treatment of fat necrosis depends on the underlying cause and the severity of symptoms. In many cases, no specific treatment is required, and the condition resolves on its own. However, if the necrosis is causing significant discomfort or cosmetic concerns, surgical removal of the affected tissue may be considered.

Prognosis

The prognosis for fat necrosis is generally good, as it is a benign condition. However, it is important to differentiate it from malignant conditions, particularly in the breast, to ensure appropriate management.

Related pages

• Adipose tissue
• Pancreatitis
• Breast cancer
• Saponification