Traumatic fat necrosis may follow trivial or unnoticed injury. Clinically, it may be difficult to differentiate from carcinoma.
Fat exuded from injured adipocytes incites a foreign body giant cell reaction with subsequent fibrosis and calcification.
Examination usually reveals a hard, irregular lump which may be tethered to the skin and accompanied by enlarged axillary lymph nodes. A history of trauma, evidence of injury, or shrinkage of the lump supports the diagnosis of fat necrosis.
Excision biopsy is required to exclude malignancy with certainty. A section through the lump reveals a pale, fibrous mass which may contain central fluid fat or chalky material.
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