Skip to main content

Main menu

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • COVID-19
    • Articles & podcasts
    • Blog posts
    • Collection
    • News
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • Classified ads
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
    • Career Ad Discount
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
Practice

Madelung disease

Fang-ying Lin and Tsung-Lin Yang
CMAJ January 08, 2013 185 (1) E79; DOI: https://doi.org/10.1503/cmaj.120191
Fang-ying Lin
From the Department of Otolaryngology (Lin, Yang), National Taiwan University Hospital and National Taiwan University College of Medicine; and the Research Center for Developmental Biology and Regenerative Medicine (Yang), National Taiwan University, Taipei, Taiwan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Tsung-Lin Yang
From the Department of Otolaryngology (Lin, Yang), National Taiwan University Hospital and National Taiwan University College of Medicine; and the Research Center for Developmental Biology and Regenerative Medicine (Yang), National Taiwan University, Taipei, Taiwan
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: yangtl@ntu.edu.tw
  • Article
  • Figures & Tables
  • Responses
  • Metrics
  • PDF
Loading

A 68-year-old man with an extended history of heavy alcohol use presented with soft, painless and slow-growing swellings over his neck, shoulders and head (Figure 1A). Magnetic resonance imaging of his head and neck showed nonencapsulated soft-tissue masses widely distributed over the superficial and deep fascial spaces (Figure 1B). Surgery was scheduled because of disfigurement and limitations of movement. Pathologic examination showed lipomatous hypertrophy, confirming our clinical diagnosis of Madelung disease. Our patient recovered from surgery uneventfully and has had no obvious recurrence for 11 months.

Figure 1:
  • Download figure
  • Open in new tab
  • Download powerpoint
Figure 1:

(A) A 68-year-old man with a long-standing history of heavy alcohol use presenting with soft-tissue swellings over his head and neck. (B) T1-weighted magnetic resonance image showing nonencapsulated masses with soft-tissue density widely distributed over the superficial and deep fascial spaces of the head, neck, back and upper trunk.

Madelung disease, also known as multiple symmetric lipomatosis, is characterized by benign, nonencapsulated fatty masses around the head and neck, the trunk and the upper extremities.1 Its prevalence is about 1:25 000 with men affected more frequently than women by a ratio of 20:1.1 The vast majority (90%) of people with Madelung disease have a history of alcoholism.1 Dysphagia and dyspnea may result from laryngeal or mediastinal involvement. The etiology of Madelung disease remains largely unknown.2 Most instances are sporadic, but a familial form characterized by maternally inherited mitochondrial gene mutation has been reported.3 Madelung disease may be associated with diabetes mellitus, hyperuricemia, hypothyroidism, liver disease or peripheral neuropathy. Its differential diagnosis includes solitary lipoma, encapsulated lipoma, familial multiple lipomatosis and liposarcoma.1

Extensive lipectomy remains the standard treatment for Madelung disease.1 There is little evidence supporting interventions beyond surgery and dealing with alcohol abuse.1 Recurrence is common. Abstinence from alcohol is not associated with spontaneous regression, but it has been reported to reduce the rate of recurrence.4

Footnotes

  • Competing interests: None declared.

  • This article has been peer reviewed.

References

  1. ↵
    1. González-Garciá R,
    2. Rodríguez-Campo FJ,
    3. Sastre-Pérez J,
    4. et al
    . Benign symmetric lipomatosis (Madelung’s disease): case reports and current management. Aesthetic Plast Surg 2004; 28:108–12, discussion 113.
    OpenUrlPubMed
  2. ↵
    1. Nisoli E,
    2. Regianini L,
    3. Briscini L,
    4. et al
    . Multiple symmetric lipomatosis may be the consequence of defective noradrenergic modulation of proliferation and differentiation of brown fat cells. J Pathol 2002;198:378–87.
    OpenUrlCrossRefPubMed
  3. ↵
    1. Gámez J,
    2. Playán A,
    3. Andreu AL,
    4. et al
    . Familial multiple symmetric lipomatosis associated with the A8344G mutation of mitochondrial DNA. Neurology 1998;51:258–60.
    OpenUrlAbstract/FREE Full Text
  4. ↵
    1. Guilemany JM,
    2. Romero E,
    3. Blanch JL
    . An aesthetic deformity: Madelung’s disease. Acta Otolaryngol 2005;125:328–30.
    OpenUrlCrossRefPubMed
PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 185 (1)
CMAJ
Vol. 185, Issue 1
8 Jan 2013
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Madelung disease
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Madelung disease
Fang-ying Lin, Tsung-Lin Yang
CMAJ Jan 2013, 185 (1) E79; DOI: 10.1503/cmaj.120191

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Madelung disease
Fang-ying Lin, Tsung-Lin Yang
CMAJ Jan 2013, 185 (1) E79; DOI: 10.1503/cmaj.120191
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Footnotes
    • References
  • Figures & Tables
  • Responses
  • Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Modern Rhesus (Rh) typing in transfusion and pregnancy
  • Remdesivir for patients with COVID-19
  • Syphilis presenting with moth-eaten alopecia
Show more Practice

Similar Articles

Collections

  • Sections
    • Clinical Images
  • Topics
    • Otolaryngology

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions

Copyright 2021, Joule Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

Powered by HighWire