Autopsy and Case Reports
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Madelung disease (multiple symmetric lipomatosis)

Linda Ferreira Maximiano; Márcio Teodoro Gaspar; Evelyn Sue Nakahira

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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.


Cell Proliferation, Lipomatosis, Multiple Symmetrical


Tadisina KK, Mlynek KS, Hwang LK, Riazi H, Papay FA, Zins JE. Syndromic lipomatosis of the head and neck: a review of the literature. Aesthetic Plast Surg. 2015;39(3):440-8. []. [PMID:25860506]

Enzi G, Busetto L, Sergi G, et al. Multiple symmetric lipomatosis: a rare disease and its possible links to brown adipose tissue. Nutr Metab Cardiovasc Dis. 2015;25(4):347-53. []. [PMID:25770761]

Plummer C, Spring PJ, Marotta R, et al. Multiple symmetrical lipomatosis—a mitochondrial disorder of brown fat. Mitochondrion. 2013;13(4):269-76. []. [PMID:23524250]

Suresh Chandran CJ, Godge YR, Oak PJ, Ravat SH. Madelung’s disease with myopathy. Ann Indian Acad Neurol. 2009;12(2):131-2. []. [PMID:20142863]

Enzi G, Inelmen E, Baritussio A, Dorigo P, Prosdocimi M, Mazzoleni F. Multiple symmetric lipomatosis—a defect in adrenergic-stimulated lipolysis. J Clin Invest. 1977;60(6):1221-9. []. [PMID:199616]

Conroy JP. Airway management: a patient with Madelung disease. AANA J. 2006;74(4):281-4. [PMID:16918119]

Ramos S, Pinheiro S, Diogo C, Cabral L, Cruzeiro C. Madelung disease: a not-so-rare disorder. Ann Plast Surg. 2010;64(1):122-4. []. [PMID:20023459]

Palacios E, Neitzschman HR, Nguyen J. Madelung disease: multiple symmetric lipomatosis. Ear Nose Throat J. 2014;93(3):94-6. [PMID:24652555]

Shibasaki ÍI, Shibasaki HI, Nakamoto TS, Baccan FS, Raposo LS. Multiple symmetrical lipomatosis (Madelung’s disease). Braz J Otorhinolaryngol. 2014;80(1):90-1. []. [PMID:24626899]

Pinto CI, Carvalho PJ, Correia MM. Madelung’s disease: revision of 59 surgical cases. Aesthetic Plast Surg. 2017;41(2):359-68. []. [PMID:28032179]

Zuber M, Pittasch D. Benign symmetric lipomatosis (Launois-Bensaude syndrome)—a rare cause of muscular weakness. Eur J Med Res. 2006;11(4):174-7. [PMID:16720284]

Enzi G. Multiple symmetric lipomatosis: an updated clinical report. Medicine (Baltimore). 1984;63(1):56-64. []. [PMID:6318013]

John DG, Fung HK, van Hasselt CA, King WW. Multiple symmetrical lipomatosis in the neck. Eur Arch Otorhinolaryngol. 1992;249(5):277-8. []. [PMID:1524810]

Carlsen A, Thomsen M. Different clinical types of lipomatosis. Case report. Scand J Plast Reconstr Surg. 1978;12(1):75-9. []. [PMID:663569]

Donhauser G, Vieluf D, Ruzicka T, Braun-Falco O. Benign symmetric Launois-Bensaude type III lipomatosis and Bureau-Barrière syndrome. Hautarzt. 1991;42(5):311-4. [PMID:1874620]

Sharma N, Hunter-Smith DJ, Rizzitelli A, Rozen WM. A surgical view on the treatment of Madelung’s disease. Clin Obes. 2015;5(5):288-90. []. [PMID:26246230]

González-García R, Rodríguez-Campo FJ, Sastre-Pérez J, Muñoz-Guerra MF. Benign symmetric lipomatosis (Madelung’s disease): case reports and current management. Aesthetic Plast Surg. 2004;28(2):108-12, discussion 113. []. [PMID:15164232]

Borriello M, Lucidi A, Carbone A, Iannone V, Ferrandina G. Malignant transformation of Madelung’s disease in a patient with a coincidental diagnosis of breast cancer: a case report. Diagn Pathol. 2012;7(1):116. []. [PMID:22937763]

Tizian C, Berger A, Vykoupil KF. Malignant degeneration in Madelung’s disease (benign lipomatosis of the neck): case report. Br J Plast Surg. 1983;36(2):187-9. []. [PMID:6831098]

Nisi G, Sisti A. Images in clinical medicine. Madelung’s Disease. N Engl J Med. 2016;374(6):572. []. [PMID:26863358]

Enzi G, Busetto L, Ceschin E, Coin A, Digito M, Pigozzo S. Multiple symmetric lipomatosis: clinical aspects and outcome in a long-term longitudinal study. Int J Obes Relat Metab Disord. 2002;26(2):253-61. []. [PMID:11850759]

Jang JH, Lee A, Han SA, Ryu JK, Song JY. Multiple symmetric lipomatosis (Madelung’s disease) presenting as bilateral huge gynecomastia. J Breast Cancer. 2014;17(4):397-400. []. [PMID:25548590]

Ardeleanu V, Chicos S, Georgescu C, Tutunaru D. Multiple benign symmetric lipomatosis: differential diagnosis of obesity. Chirurgia. 2013;108(4):580-3. [PMID:23958107]

Meningaud JP, Pitak-Arnnop P, Bertrand JC. Multiple symmetric lipomatosis: case report and review of the literature. J Oral Maxillofac Surg. 2007;65(7):1365-9. []. [PMID:17577504]
















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