Benign symmetric lipomatosis (Madelung's disease): a case report
Ozen Oz Gul1, Mustafa Merter2, Soner Cander1, Oguz Kaan Unal1, Erdinc Erturk1 & Sazi Imamoglu1
Benign symmetric lipomatosis (BSL) is a very rare disorder characterized by the growth of uncapsulated masses of adipose tissue, predominantly located in the neck and shoulders. Benign symmetric lipomatosis is usually described in adults between 30 and 60 years of age and is slightly more frequent in men with heavy alcohol consumption. A 70-year-old woman presented with a great growth of soft tissues in the cervico-occipital region who had never consumed any alcohol. Laboratory evaluation revealed a chronic anemia, mild leukopenia, increased erythrocyte sedimentation rate. Cervical magnetic resonance imaging (MRI) showed large amounts of fatty masses in the posterior neck and occipital region with no mediastinal involvement. Fine-needle aspiration led to the diagnosis of nonspecific fibroadipose tissue. Since she could not lay down on her back we recommended her surgery but she didnt accept. At this writing there has no history dyspnea or dysphagia during one year of follow-up observations. Benign symmetric lipomatosis may be asymptomatic, but in some cases, due to mediastinal involvement, dyspnea or dysphagia can occur. The ethiology of BSL is unknown, but an abnormal lipogenesis induced by catecholamines has accused. Diagnosis of BSL can be established with the clinical signs and image tests. The treatment for BSL is surgery (open approach and/or liposuction), and it is reserved for patients with aesthetic deformities, psychological problems or aerodigestive dysfunctions.