Introduction: Madelungs 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 1018 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.
27 Apr - 01 May 2013
European Society of Endocrinology