Fat necrosis as a differential diagnosis for recurrence in a treated case of breast cancer: A case report

Fat necrosis is a benign inflammatory process that can involve adipose tissue that most frequently affects peri-menopausal women. It can mimic breast cancer clinically or radiologically. The incidence of breast fat necrosis overall is roughly 0.6%, representing 2.75% of all benign lesions. Fat necrosis presents in 0.8% of breast tumors and 1–9% of breast reduction surgery cases. Most at risk are middle-aged women, with an average age of 50 years, and women with pendulous breasts. Traumatic Fat Necrosis is an important differential diagnosis to be kept in mind in Carcinoma Breast patients who are treated with surgery and adjuvant radiation therapy. We present a case where radiation is followed by a large non-healing ulcer in a known case of breast carcinoma patient.

Case report: epipericardial fat necrosis, a rare cause of chest pain

Background Epipericardial fat necrosis (EFN) is a rare cause of chest pain which is often unrecognized. Case summary A 58 year-old male previously known with a transient ischaemic attack presented with a sharp, substernal chest pain. Pulmonary embolism was ruled out by computed tomography (CT) angiography. However, CT angiography revealed an inhomogeneous epipericardial mass. On cardiovascular magnetic resonance imaging (CMR) the mass had an inhomogeneous signal intensity without infiltration of surrounding tissue. Late gadolinium enhancement imaging showed subtle hyperenhancement. Tissue characterization by means of parametric mapping revealed very low native T1 relaxation times and increased T2 relaxation times. In conclusion, the epipericardial mass showed fibro-fatty inflammatory markers, suggestive of EFN. The chest pain resolved spontaneously. Follow up CT 3 months later showed a marked regression of the mass which confirmed the diagnosis EFN. Discussion EFN is a benign and self-limiting inflammatory cause of chest pain which can be diagnosed with multi-modality imaging and must not be overlooked in the differential diagnosis of patients with acute pleuritic chest pain.

Encapsulated cyst fat necrosis masquerading as cold abscess

Encapsulated fat necrosis is a benign, usually asymptomatic and underreported condition. It is believed to be trauma‐related ischemia and necrosis of fat tissue that gradually detaches from its surroundings. Here we reported a case of encapsulated cyst fat necrosis in a 75 years old female following intramuscular injection, who was clinically diagnosed as cold abscess initially.

Retroperitoneal Fat Necrosis in Response to an Episode of Acute Pancreatitis

Acute pancreatitis can result in fat necrosis, typically occurring in the peripancreatic region within weeks to months, and it generally appears as a low attenuation collection, with minimal heterogeneity. There are no specific imaging features that can diagnose retroperitoneal fat necrosis which may imitate other entities including certain malignancies, which may lead to invasive studies for diagnosis. Herein, we present a case of extensive retroperitoneal fat necrosis beyond the peripancreatic region that developed 10 days after an episode of acute pancreatitis.

Pseudoprogression of Malignant Peripheral Nerve Sheath Tumor in Patient with Neurofibromatosis Type 1, a Case Report

Pseudoprogression, defined as the radiographic false appearance of disease progression, is not frequently observed in patients with malignant peripheral nerve sheath tumor (MPNST). We report on a case of a patient with neurofibromatosis type 1 (NF1) MPNST pseudoprogression that presented as suspected local recurrence 9.5 years after last treatment. The patient underwent surgical resection following growth of a mass on sequential MRI imaging; surgical pathology, however, showed skeletal muscle with atrophy, fibroadipose tissue, and fat necrosis, without any evidence of tumor. As MPNST survival rates increase, physicians should consider pseudoprogression as a potential presentation after prior treatment.