Madelung’s disease also called benign symmetric lipomatosis is a rare disorder of unknown etiology. The disease affects almost exclusively middle-aged men with a history of multi-year alcohol abuse. The major symptom is presence of non-encapsulated benign fat masses, especially in the area of the head and neck. Limited head and neck movement, dysphagia, and dyspnea may appear as well. The diagnosis is clinical and is supported by imaging methods, often elevated hepatic enzymes in blood serum, and histological examination with finding of mature adipose tissue without signs of proliferation. Therapeutic methods involve liposuction or excision which is a method of choice nowadays. In this article the authors review current knowledge, research state, and present five cases of the Madelung’s disease occurring within the last 10 years at the Clinic of Otorhinolaryngology and Head and Neck Surgery in Martin, Slovakia.
In head and neck cancers the occurrence of nodal metastases is the most important prognostic factor. Their early diagnosis is crucial for proper treatment. Detection of early metastases is still very difficult. Predictive diagnostic methods such as the sentinel lymph node detection is limited by the occurrence of skip metastases. At our Clinic we prefer a selective neck dissection based on a surgical treatment of predilected lymphatic spread area for each type of head and neck tumor with a preservation of non-lymphatic structures of the neck. The main objective of this article is to analyze the distribution of neck metastases and to study the frequency of skip metastases in head and neck cancer.
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