Madelung disease (multiple symmetric lipomatosis)

Abstract

Madelung disease or multiple symmetric lipomatosis (MSL) is a rare entity among the overgrowth syndromes. It is characterized by painless non-encapsulated and symmetric fatty deposits in the neck, torso, mammary, and abdominal areas, and in the upper and lower limbs. The etiology of the disease is still unknown. Chronic alcohol consumption may play a role in adipocyte hyperplasia in genetically susceptible individuals. Besides the overgrowth of adipose tissue, patients with MSL present features of metabolic syndrome. Patients seek medical attention usually for esthetic reasons. We present the case of a middle-aged man who sought the outpatient clinic complaining of bulging masses in the posterior upper part of the thorax, the occipital area, and the neck. The masses grew over a period of 2 years. The physical examination and imaging study revealed the presence of symmetric lipomatosis. A two-step surgical treatment was undertaken for the excision of the lipomatous tissue. The postoperative outcome was uneventful with satisfactory esthetic results.

Giant scrotal lipoma in Madelung's disease: A case report

“…Madelung's disease is a rare condition with an incidence of approximately 1 in 25,000 patients. The disease is more commonly encountered in Mediterranean countries than the rest of the world and predominantly affects men between 30 and 60 years of age (male:female ratio = 15:1) with a history of alcoholism [1] , [9] . Special cases have also been described in children [1] .…”

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

“…Cases also presented MD as a metabolic syndrome. Three had hypertension[ 29 , 33 , 41 ], two had diabetes mellitus[ 29 , 37 ], and one patient had bronchiectasis, hypercalcemia, and high triglycerides at the same time, accompanied by impaired glucose tolerance[ 35 ]. Additionally, 10 patients had a drinking habit per day, 9 (69.2%) were heavy drinkers[ 8 , 29 , 31 - 34 , 36 , 37 , 39 ], and 1 had alcoholic fatty liver[ 34 ].…”

Multidisciplinary diagnostic dilemma in differentiating Madelung’s disease — the value of superb microvascular imaging technique: A case report

“…However, there is no consensus on the optimal surgical approach, and the overall recurrence rate is up to 63%[ 23 , 25 ]. Despite the high recurrence rate, the surgical approach must be considered as MSL also affects social life and worsens overall quality of life[ 26 ]. The histological investigation of the surgical material is essential, as there is always a small risk of liposarcoma.…”