Type 1C Multiple Symmetrical Lipomatosis: A Cause of Misdiagnosis in Females.

Multiple symmetrical lipomatosis (MSL) is a disease that causes symmetrical fat deposits in the neck, shoulders, and upper trunk. It is more common in the neck area in men who consume alcohol. The male-to-female ratio varies from 15:1 to 30:1. Madelung's disease has been reported in a small number of female patients who do not consume alcohol. Pseudoathletic appearance (MSL type 1C) is rare and causes misdiagnosis. We would like to present a 50-year-old woman with an athletic appearance who had fat deposits on her shoulders and upper chest. After excluding obesity and Cushing's syndrome, which were initially considered, we aimed to remind people of this entity that causes symmetrical fat deposits in the upper trunk in females.

Madelung's Disease: Analysis of Clinical Characteristics, Fatty Mass Distribution, Comorbidities and Treatment of 54 Patients in China.

Purpose: Madelung's disease (MD) is a rare disease characterized by the deposition of unencapsulated fat masses on the face, neck, chest, back and other areas of patients. The aim of the study was to analyze the clinical characteristics, comorbidities and treatment of MD in Chinese populations. Patients and Methods: We retrospectively reviewed the medical records of 54 patients who were diagnosed with MD at the Affiliated Hospital of Qingdao University and Qingdao Municipal Hospital from January 2005 to February 2021 and collected the subjects' demographic information, clinical indicators, location of fat deposits, treatment, complications and prognostic data. Results: Among 54 MD patients in the study, only 1 (1.85%) was female, and the subjects had an average age of 56.65 ± 7.93 years. More than 70% of patients had a history of long-term smoking or/and alcohol abuse. In our study, type I accounted for approximately 61.11% of cases according to Donhauser's classification, and almost all patients had neck fat deposition. MD patients often have multiple comorbidities across several systems, such as the endocrine, digestive, circulatory, urinary, and neurological systems. Among these, endocrine system diseases were the most common comorbidities in our study, accounting for 81.48%. Notably, up to 20.37% of cases were complicated with cancer, especially digestive system tumors. More than 70% of the patients received surgical treatment, and nearly 40% experienced postoperative recurrence. Conclusion: Considering that MD patients often have comorbidities of multiple systems and that a small number of cases are even complicated by cancer, we recommend that clinicians comprehensively assess a patient's condition and complications, advocate that patients quit consuming alcohol and smoking as soon as possible, establish healthy dietary and living habits, and formulate individualized and comprehensive diagnosis and treatment plans.

Diagnostic and surgical challenges of progressive neck and upper back painless masses in Madelung's disease: A case report and review of literature.

BACKGROUND: Madelung's disease (MD) is a chronic alcoholism-associated metabolic syndrome characterized by symmetrical subcutaneous deposition of adipose tissue in the head, neck, shoulders, back, trunk, and nerve roots of the upper and lower limbs. It is relatively rare in Asian individuals and is prone to misdiagnosis. Herein, we report a case of a patient with MD who had undergone surgical management at our hospital, and we discuss the pathogenesis, diagnosis, and treatment of MD. CASE SUMMARY: We report a case of MD in a 65-year-old man of Han descent. The patient had multiple, painless progressive masses for more than five years in the neck and more than 30 years in the upper back. Because of neck mobility limitations and progressive cosmetic deformities caused by the masses, he was admitted to our hospital. He drank approximately 500 mL of liquor per day and smoked heavily for more than 30 years. Contrast-enhanced computed tomography of the neck and chest documented abundant unencapsulated, subcutaneous fatty deposits. We prepared a staged operation plan. The patient was diagnosed with MD; he was advised to abstain from alcohol and was followed up regularly. After a 3-month follow-up, no recurrence of fat accumulation was found in the surgical areas. CONCLUSION: This report presents a case of surgical treatment for MD to improve clinicians' understanding of the disease.

Bilateral symmetric lipomatosis of the orbit in Madelung's disease.

Madelung's disease is a rare benign systemic lipomatosis, which often presents in the head, neck and upper trunk regions. The appearance of symmetrical, excessive adipose tissue in the subcutaneous layer is its clinical characteristic. Orbital involvement is unusual with only a few cases reported previously. In this study, we describe the clinical and radiological features of Madelung's disease in the orbits. A 42-year-old man with alcohol addiction presented with chronic bilateral masses of the lower eyelids and proptosis. Computed tomography (CT) scan showed excessive symmetrical non-encapsulated fat deposition in the orbital fat, lower eyelids, salivary glands, subcutaneous tissue along the neck and under the sternocleidomastoid muscles and supraclavicular areas bilaterally. Histopathological study of the orbital masses revealed mature adipose tissue interspersed with thin fibrous septae. He developed recurrent lipomatosis 1 year after surgical excision.

Benign symmetric lipomatosis (Madelung's disease) with concomitant incarcerated femoral hernia: A case report.

BACKGROUND: Benign symmetric lipomatosis (BSL) was first described by Brodie in 1846 and defined as Madelung's disease by Madelung in 1888. At present, about 400 cases have been reported worldwide. Across these cases, surgical resection remains the recommended treatment. Here we report a case of neck BSL with concomitant thick fatty deposit in the inguinal region, which concealed the signs of a right incarcerated femoral hernia. CASE SUMMARY: A 69-year-old male patient was admitted to our hospital with "abdominal pain, abdominal distension, nausea-vomiting and difficult defecation for half a month". Moreover, he had a mass in the right inguinal region for more than 10 years. An egg-sized neck mass also developed 15 years ago and had developed into a full neck enlargement 1 year later. In addition, the patient had a history of heavy alcohol consumption for more than 40 years. With the aid of computerized tomography scan, the patient was diagnosed with BSL and a low intestinal mechanical obstruction caused by a right inguinal incarcerated hernia. Under general anesthesia, right inguinal incarcerated femoral hernia loosening and tension-free hernia repair was performed. However, this patient did not receive BSL resection. After a 1-year follow-up, no recurrence of the right inguinal femoral hernia was found. Moreover, no increase in fat accumulation was found in the neck or other areas. CONCLUSION: Secretive intraperitoneal fat increase may be difficult to detect, but a conservative treatment strategy can be adopted as long as it does not significantly affect the quality-of-life.

Parapharyngeal space lipomatosis with secondary dyspnea, disphagia and disphonia.

INTRODUCTION: Parapharyngeal space tumors are a small percentage of all head and neck neoplasms. Due to their anatomic location, they represent a therapeutic challenge. To our knowledge, 11 cases of parapharyngeal lipomatous tumors have been reported in the literature. CASE: A 48 year old male with chief complaints of dyspnea, dysphagia and dysphonia was found to have a parapharyngeal space tumor. He was scheduled to undergo lumpectomy and neck exploration. DISCUSSION: Benign tumors represented 70% of all cases. Open neck surgery is considered the gold-standard of treatment. CONCLUSION: It is important to bear in mind the lipomas of the parapharyngeal space to establish an accurate diagnosis and implement timely, appropriate treatment in order to avoid future complications and reduce morbidity and mortality.

Imaging Features of Madelung's Disease: Case Report

Madelung's disease, or benign symmetric lipomatosis, is an uncommon disorder that is characterized by massive symmetrical deposits of adipose tissue in the upper trunk, neck and head, and is usually associated with alcohol abuse; as such, patients usually complain of cosmetic issues. Historically, Madelung's disease is usually encountered in men between 30 and 60 years of age, and is more prevalent in the Mediterranean population. In this case study, we describe a rare case of Madelung's disease, in an Asian patient who presented with symmetrically located bilateral masses in the anterior neck, which grew progressively larger over a period of seven years.

Case report of comorbid alcohol-induced psychotic disorder and Madelung's disease.

Madelung's disease, also known as benign symmetric lipomatosis (BSL), multiple symmetric lipomatosis (MSL), fatty neck syndrome or Launois-Bensaude syndrome, is a rare disease characterized by the presence of multiple, symmetric, loose adipose tissues distributed around the neck, occipitalis, shoulder, back or chest. The fat masses are non-encapsulated and therefore can move freely between adjacent areas. This disease is most commonly seen among middle-aged Caucasian men of Mediterranean origins; it is rarely reported in Asia. Among individuals with Madelung's syndrome, 60 to 90% have a history of chronic alcohol abuse. We report a case of a 51-year-old Chinese man with a history of alcohol use disorder who had fat masses in his neck which gradually enlarged over a period of three years. Based on the case history and the results of physical examination, neck CT and other routine tests, he was diagnosed with Madelung's syndrome.

Facelift- and circum-occipital incision placement for fat extirpation of the neck in Madelung's disease - a two-case report.

Benign symmetric lipomatosis (Madelung's disease) is a rare disorder of fat metabolism that is characterized by progressive symmetrical formation of unencapsulated and painless excess fat masses around the neck and trunk that result in cosmetic disfiguration and functional impairment. Since the disorder is incompletely understood and causal therapy is unavailable, surgical removal of fatty masses is the mainstay of treatment. In this paper the authors describe their use of the classical facelift incision placement as well as a horizontal circum-occipital incision to approach and excise excess fat of the anterior and posterior neck in two patients. This method yielded satisfying results with a combination of good access to fat masses, smooth trimming and redraping of redundant skin, in addition to fairly inconspicuous scarring post-operatively. After removal of 1.5 kg of fat from each patient and a period of uncomplicated wound healing, both patients showed no signs of relapsing fatty growth. Although more challenging than most conventional approaches, the authors' technique has shown good outcomes in those treated with this condition.

Doença de Madelung: relato de caso e revisão da literatura / Madelung's disease: a case report and literature review

Relata-se o caso de um paciente portador da doença de Madelung, definida clinicamente pela presença de múltiplos acúmulos de tecido adiposo não encapsulados, usualmente envolvendo a região cervical e superior do tórax, de distribuição simétrica. O exame de imagem eleito para confirmação do diagnóstico foi tomografia computadorizada, por ser menos dispendiosa e mais acessível, comparando-se à ressonância magnética.

The authors report the case of a patient with Madelung's disease, which is clinically described as the presence of multiple and symmetric non-encapsulated masses of fatty tissue, usually involving the neck and the upper region of the trunk. Computed tomography was selected as the imaging method for diagnosis confirmation, considering its lower cost and higher availability as compared with magnetic resonance imaging.

A Case of Benign Symmetric Lipomatosis Limited to the Face / 대한피부과학회지

Benign symmetric lipomatosis is a very rare disease that's characterized by a symmetric accumulation of excessive amounts of adipocytes. The lesions are located mainly on the neck, trunk and proximal extremities. Although its etiology is unknown, it has been described to be associated with a heavy alcohol intake. A 51-year-old woman presented with a two year history of ill-defined soft masses on both mandibular areas. We made the diagnosis of benign symmetric lipomatosis according to the histopathologic examination. As a difference from other reports of benign symmetric lipomatosis, our patient was non-drinker for her past history. We present here a case of benign symmetric lipomatosis at an unusual predilection site and this developed in a non-drinker.

A Case of Benign Symmetric Lipomatosis / 대한피부과학회지

Benign symmetric lipomatosis is a rare disease of undetermined cause characterized by massive symmetric depositions of adipose tissue, predominantly on the neck, shoulder, back, and upper extremities. A 60-year-old man with chronic alcoholism was referred to our clinic for symmetric, skin-colored, non-tender masses on the posterior neck, both clavicular areas, abdomen, and back for about 10 years. He had been managed for tingling sensation on both hands in the neurologic department. Nerve conduction velocity studies were consistent with sensorimotor polyneuropathy and histopathologic findings revealed that the reticular dermis was replaced by normal uncapsulated mature fat cells. We report a rare case of benign symmetric lipomatosis associated with polyneuropathy.

A Case of Benign Symmetric Lipomatosis

Benign symmetric lipomatosis is characterized by diffuse symmetric deposits of nonencapsulated fat, generally affecting the cervical and upper dorsal regions. There is a history of alcohol abuse in nearly all the cases. It is rarely reported in non-drinkers. Herein we report a 63-year-old man presenting with one year's history of multiple ill-defined symmetric soft mass on posterior neck, upper trunk and upper extremities without the history of alcohol abuse. We ad-ministered corticosteroid orally due to osteoarthritis of the knee for a long time.

A Case of Benign Symmetric Lipomatosis / 대한피부과학회지

Benign symmetric lipomatosis is characterised by diffuse symmetric deposits of adipose tissue, predominantly on the neck, shoulder, back and upper extremities. We report a case of benign symmetric lipomatosis in a 61-year-old-man, which was first noted one year previously. It began growing rapidly about 3 months ago and was associated with alcoholic liver disease. Histopathological findings showed that the reticular dermis had been replaced by normal uncapsulated mature fat cells that were slightly increased in number in the fibrous connective tissue. He was treated with theophylline 300mg/day for two months.

Three cases of benign symmetric lipomatosis / 대한피부과학회지

Benign symmetric lipomat,osis is a rare disease of undetermined cause characterized by symmetric deposits of adipose tissue o:n the neck, upper trunk and abdomen. We report three cases of kienign symmetric lipomatosis, one of which is associated with alcoholic liver disease and the patient complained of a diffieulties in neck motion, All of them are about sixty year old men with history of frequent alcohol consumption. In histopathologic findings, the reticular dermis was completcly replaced by mature fat cells and there was a slight increase in vascular and fibrous elements.

A Case of Benign Symmetric Lipomatosis / 대한피부과학회지

Benign symmetric lipomatosis is characterized by massive symmetric fat deposition, predominantly in the neck and shoulder girdle ares. We present a case of benign symmetric lipomatosis with alcoholic liver cirrhosis in a 54-year-old man. About two years ago, solitary skin-colored, non-tender swelling on the right upper arm was developed. The lesion had been aggravsted abruptly and rapidly in size and distribution since about one month ago. Histopathologic findings showed completely replaced reticular dermis and invaded subcutaneous tissue by mature fat cells.