ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2013) 32 P783 | DOI: 10.1530/endoabs.32.P783

Madelung's disease: a case report

Georgina Jorge1, Joana Queirós1, Joana Mequista1, Ana Oliveira1, Pedro Silva2 & Davide Carvalho1,2

1S. JOAO Hospital, Porto, Portugal; 2University of Porto Medical School, Porto, Portugal.

Introduction: Madelung’s disease is a rare disorder characterized by a disturbance in the adipocyte metabolism. Mainly occurs in alcoholic Mediterranean male, presenting multiple, symmetrical lipomas.

Case report: A 49-year-old obese man with a history of alcoholism, complaint of weight gain, soft and slow-growing swelling of the neck, and shoulders. His past history: epilepsy, alcoholic CHD, hypothyroidism, severe sleep apnea, vitiligo and HTA. His (BMI 52 kg/m2), symmetrical subcutaneous masses between 10–18 cm, of nuchal, cervical, mandibular, upper back torso and upper and lower arms, freely movable, painless and non tender. Lab tests: IGT, and hepatic dysfunction. An abdominal CT scan: hepatic cirrhosis with intense proliferation of mesenteric fat. The diagnosis was made on the basis of history and clinical examination. Owing to portal hypertension, he is not eligible for gastric bypass surgery, and was enrolled in a nutritional plan.

Conclusion: This patient bears the hallmarks of this disease that, although rare, should not be underestimated. Abstinence from alcohol may only prevent further progression in the size of fat masses. Lipectomy and liposuction are the treatments of choice.

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