Multiple symmetric lipomatosis: Report of a case and discussion on treatment options

Multiple symmetric lipomatosis (Madelung's disease) is a very rare syndrome characterized by multiple and symmetrical subcutaneous fatty masses that usually involve the upper third of the body. Etiology and pathogenesis of this disease remain unclear, even if a strong association with chronic alcohol abuse has been observed. Growth of the lipomatous lesions is slowly progressive and may lead to huge symptomatic masses. Interruption of alcohol abuse and surgical excision are the only effective treatments. We report the case of a 54-years-old man with Madelung's disease. The patient presented multiple asymptomatic fatty masses in the neck and upper trunk and a huge recurrent lipoma in the posterior cervical region limiting his neck movements. He underwent surgical excision of this latter mass with an uneventful post-operative course and good functional and aesthetic results. The patient is well fit 36 months after surgery, with no signs of local recurrence. Therefore we conclude that surgery is the treatment of choice in patients affected by Madelung's disease with large symptomatic lipomatous masses.