Computed tomography of deep fat masses in multiple symmetrical lipomatosis.

Abstract

Deep fat masses were evaluated by computed tomography (CT) in 15 patients with multiple symmetrical lipomatosis. In 4 patients, peritracheal accumulations of fat were observed. In 3 of them, tracheal compression by lipomatous tissue was demonstrated: 2 were asymptomatic and the third had severe respiratory insufficiency secondary to blockage of the airway by the vocal cords as the result of recurrent nerve palsy. In 6 patients, lipomatous tissue occupied the potential space between the spinal scapulae and the trapezius, supraspinatus, and infraspinatus muscles. In 2, calcification of lipomatous masses was observed. There was no relationship between extension of subcutaneous fat and accumulation at deep sites. CT facilitates early detection of peritracheal lipomatous tissue and is helpful in follow-up when deep fat accumulation is responsible for space-occupying lesions requiring surgery.

Unusual Cases of Multiple Symmetrical Lipomatosis with Neurological Disorders

“…MSL has been classified as type I (for some authors the real Madelung's disease) characterized by masses distributed in the upper half of the body, weight loss and possible deep accumulation of adipose tissue (ie, mediastinal), and type II which is more difficult to differentiate from simple obesity with diffuse involvement, weight gain and the absence of deep involvement. 3,4 The two cases reported here can be classified in the type I group. They are associated with the same neurological manifestations, polyneuropathy and memory disorders.…”

“…The polyneuropathy affects the cases with MSL as mentioned by other authors. [4][5][6][7][8] It may appear as an autonomic, sensory or motor neuropathy with proximal predominance, and may be associated with neuropathic skin lesions and Charcot's arthropathy. 9 Neuropathy is a frequent complication of alcoholism but many publications distinguish polyneuropathy in MSL patients from alcoholism.…”

Rare adipose disorders (RADs) masquerading as obesity

“…Over 300 adult cases are reported in the literature with an age range of 20-71 years. The early literature on MSL was dominated by research on alcoholic men with a reported incidence of 1/25 000 in the Italian population [35] . Non-alcoholics and women are also affected [36][37][38] ; two cases have been reported in children [39,40] .…”

Launois-bensaude syndrome: A benign symmetric lipomatosis without alcohol association

“…Thus, in Type 1, intramediastinal localization might originate a vena cava syndrome and tracheal compression. [7] It might present also a slight decrease in cervical amplitude, intertrigo folds, and clothing discomfort, in addition to metabolic complications and disorders related to chronic alcoholism. In our case, blood urea and cholesterol levels as well as liver tests were normal, and the patient did not have any history of alcoholism and was devoid of complications of alcohol abuse.…”