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Related Experiment Video

Updated: Jan 16, 2026

A Microphysiologic Platform for Human Fat: Sandwiched White Adipose Tissue
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The 'split fat sign' revisited.

S Crompton1, N Kotnis1

  • 1Sheffield Teaching Hospitals NHS Foundation Trust, Herries Road, Sheffield, South Yorkshire, S5 7AU, UK.

Clinical Radiology
|October 1, 2025
PubMed
Summary

The "split fat sign" on MRI, seen in soft tissue tumors, can appear in both benign and malignant cases. Radiologists should not assume this sign indicates a benign lesion, especially for deep-seated tumors.

Area of Science:

  • Radiology
  • Oncology
  • Pathology

Background:

  • The 'split fat sign' describes fat surrounding soft tissue tumors on MRI.
  • It was first identified in 1999, initially for neurogenic neoplasms.

Purpose of the Study:

  • To review the etiology and prevalence of the 'split fat sign'.
  • To differentiate its appearance in benign versus malignant soft tissue tumors.
  • To clarify its significance in intermuscular and intramuscular locations.

Main Methods:

  • Literature review of studies on soft tissue tumors and MRI findings.
  • Analysis of the 'split fat sign' in intermuscular and intramuscular locations.
  • Comparison of the sign in benign and malignant lesions.

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Main Results:

  • The 'split fat sign' refers to fat in the intermuscular plane or surrounding intramuscular tumors ('fatty rind', 'peritumoral fat').
  • This sign can be present in both benign and malignant intermuscular lesions.
  • While often associated with benign tumors, perilesional fat also occurs in malignant intramuscular lesions.

Conclusions:

  • The presence of perilesional fat on MRI is not pathognomonic for benign soft tissue tumors.
  • Radiologists must consider malignancy even with a 'split fat sign'.
  • Diagnostic uncertainty warrants review at a specialized soft tissue sarcoma center.