Journal of Case Reports and Reviews in Medicine (ISSN: 3069-0749)
Case Report Volume: 1 & Issue: 4
Abstract
Fat necrosis is a rare benign condition in which adipose tissue undergoes ischemic or inflammatory changes, often presented as a mass or soft tissue nodule. Its pathophysiology remains unclear, with trauma and ischemia considered primary causes. Abdominal fat necrosis may mimic malignancy, making it challenging to diagnose based on imaging alone.
We report the case of a 35-year-old woman who presented with two months history of abdominal pain, and palpable nodules in the anterior abdominal wall. A prior cesarean section performed eleven years earlier was her only relevant medical history. Contrast-enhanced CT scan revealed ill-defined enhancing soft tissue thickening and stranding involving anterior abdominal wall extending posteriorly to involve omentum and peritoneal fat with soft tissue nodularity of the omentum and circumferential thickening of the wall of adjacent transverse colon. The imaging findings raise suspicion of malignancy, specifically peritoneal carcinomatosis, with a differential diagnosis of chronic inflammatory process. The ultrasound-guided core biopsy revealed chronic inflammation and fat necrosis, excluding malignancy. The patient received anti-inflammatory therapy, and follow-up imaging showed mild interval regression in the lesion size.
This case highlights the diagnostic challenges in differentiating fat necrosis from malignancy on imaging alone, emphasizing the importance of integrating clinical history, imaging, and histopathology for accurate diagnosis. Prompt recognition and appropriate management can lead to successful outcomes in patients with fat necrosis.
Keywords: Fat necrosis, Chronic inflammation, Malignancy, Peritoneum, Omentum