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Frąk W, Gocel O, Sieniawski K, Sieniawska J, Włodarczyk M, Dziki L. Multiple symmetrical lipomatosis: A literature review and case report of a patient with Madelung's disease. POLISH JOURNAL OF SURGERY 2023; 96:130-134. [PMID: 38348992 DOI: 10.5604/01.3001.0053.5997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
<b><br>Introduction:</b> Madelung's disease is a rare condition characterised by the symmetric growth of fatty tumours (lipomas) around the neck, shoulders, upper arms and trunk.</br> <b><br>Case report:</b> We present a description of a male patient with extensive adipose tissue overgrowth around the neck. Once the possibility of malignancy was excluded, the patient's history and clinical and radiological findings led to the diagnosis of Madelung's disease. A two-stage surgery was planned and the patient underwent lipectomy of the lipomas around the neck.</br> <b><br>Conclusions:</b> This article analyses the clinical data with Madelung's disease; discusses its aetiology, clinical manifestations, diagnosis and treatment methods; and provides help with clinical diagnosis and treatment.</br>.
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Affiliation(s)
- Weronika Frąk
- Department of General and Oncological Surgery, Medical University of Lodz, Poland
| | - Oliwia Gocel
- Department of General and Oncological Surgery, Medical University of Lodz, Poland
| | - Karol Sieniawski
- Department of General and Oncological Surgery, Medical University of Lodz, Poland
| | - Joanna Sieniawska
- Department of Dermatology, Pediatric Dermatology and Oncology Clinic, Medical University of Lodz, Poland
| | - Marcin Włodarczyk
- Department of General and Oncological Surgery, Medical University of Lodz, Poland
| | - Lukasz Dziki
- Department of General and Oncological Surgery, Medical University of Lodz, Poland
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Yu H, Li H, Ye P, Wu M. Surgical Treatment of Madelung’s Disease: Case Report and Literature Review. Indian J Surg 2022. [DOI: 10.1007/s12262-022-03616-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Jia Y, Wang J, Deng W, Han J, Dong H, Leng X. Giant intermuscular lipoma of hip: A case report. Int J Surg Case Rep 2022; 94:107121. [PMID: 35658292 PMCID: PMC9171524 DOI: 10.1016/j.ijscr.2022.107121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/20/2022] [Accepted: 04/20/2022] [Indexed: 11/28/2022] Open
Abstract
Introduction Presentation of case Discussion Conclusion Compared with other lipomas on the body surface, our reported lipomas in the deep tissues are very rare. Lipomas are a common benign tumor, but huge lipomas are rare and may be malignant. After the operation, the lipoma was removed and the symptoms of nerve compression of the patient were obviously relieved.
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Affiliation(s)
- Yuyan Jia
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun 130117, Jilin Province, China
| | - Jianyu Wang
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun 130117, Jilin Province, China
| | - Wei Deng
- The Affiliated Hospital of Changchun University of Chinese Medicine, Changchun 130117, China
| | - Jicheng Han
- The Affiliated Hospital of Changchun University of Chinese Medicine, Changchun 130117, China
| | - Haisi Dong
- Jilin Ginseng Academy, Changchun University of Chinese Medicine, Changchun 130117, Jilin, China.
| | - Xiangyang Leng
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun 130117, Jilin Province, China.
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Zewde YZ. Madelung's disease in a non-alcoholic Ethiopian male patient mistaken for obesity: a case report. BMC Endocr Disord 2021; 21:142. [PMID: 34217263 PMCID: PMC8254943 DOI: 10.1186/s12902-021-00803-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/21/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Madelung's disease (MD) is a rare disorder of fat storage characterized by the presence of diffuse, symmetrical deposition of subcutaneous fat around the neck, shoulder, arm, trunk and thigh. Although its cause is not fully understood, this benign condition is commonly presented among adult males with Mediterranean origin and history of alcohol abuse. Patients often presents with compression of vital structures, cosmetic disfigurement and associated psychosocial problems and systemic comorbidities. It is often under-recognized by physicians, possibly due to obliviousness of the condition and often misdiagnosed as obesity. CASE PRESENTATION We present a 65-year-old non-alcoholic black Ethiopian man, presented with a slowly growing body fat in his trunk and proximal limbs associated by multiple joint and back pain which got worse recently. He denied any history of chronic alcohol use. On examination, huge, bilateral, non-tender, soft, globular masses in his torso, shoulder, arm and thigh with bilateral breast enlargement. On investigation his biochemical profile was normal except hyperuricemia (10.6 mg/dl). Imaging of the cervical and lumbar vertebrae showed excess subcutaneous fat depositions with degenerative disc disease. Biopsy from the mass revealed non-encapsulated lipoma and he was diagnosed with type II MD. We treated his pain with supportive therapy and discharged in stable condition. The patient deferred surgical treatment. CONCLUSIONS Madelung's disease is often reported among white adult males with chronic alcoholism. However, our case reported a black man without the typical risk factor which was misdiagnosed as obesity. Hence, clinicians should be aware of MD and need to consider it in their differential diagnosis when encountered with a patient having progressive centripetal fat deposition with or without a history of alcoholism and systemic comorbidities. As early detection of this disorder helps to avoid diagnostic delays and prevent complications through timely interventions which will in turn improves patient quality of life.
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Affiliation(s)
- Yared Zenebe Zewde
- Department of Neurology, College of Health Sciences, Addis Ababa University, P. O. Box: 41690, Addis Ababa, Ethiopia.
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Liu Q, Lyu H, Xu B, Lee JH. Madelung Disease Epidemiology and Clinical Characteristics: a Systemic Review. Aesthetic Plast Surg 2021; 45:977-986. [PMID: 33492475 DOI: 10.1007/s00266-020-02083-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 11/15/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Madelung disease is a rare lipid metabolic disorder, and most cases are sporadically reported. There are currently no systematic reviews summarizing the epidemiological and clinical characteristics of this disease. The purpose of the current article is to extract and analyze the existing evidence concerning Madelung disease derived from case series in order to provide adequate treatments for patients based on a more comprehensive understanding of the disease. METHODS PubMed, Embase, and Web of Science databases were queried for relevant articles using the search terms "Madelung disease," "multiple symmetric lipomatosis," "Launois-Bensaude syndrome" and synonyms until Aug 31,2020. Data statistics of Madelung disease epidemiology and clinical characteristics are summarized in different tables or charts with Microsoft Office software. RESULTS Patients exhibiting Madelung disease were mostly located in Europe, although some records existed in Asia as well. Average patient age was between 45 and 65 years old. Type I was the most common form of the disease, and the neck was the most common location for tumors. Madelung disease is associated with various metabolic disorders, and hematoma and seroma were the most common complications. Overall recurrence rate was 18.3%, with similar recurrence rates after lipectomy and liposuction. Fewer complications occurred after liposuction compared with lipectomy, but relapse was more common after liposuction. CONCLUSION Madelung disease consists of specific epidemiological and clinical characteristics, knowledge of which can be helpful for diagnosis and cognition. Lipectomy and liposuction are considered to be the most effective treatment methods for Madelung disease; however, choice of surgery should be based on comprehensive consideration of the disease, such as severity, mass location, and patient expectations. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Quanzhe Liu
- Department of Orthopedic Surgery, College of Medicine, Seoul National University, Seoul, Korea
| | - Haozhen Lyu
- Department of Orthopedic Surgery, College of Medicine, Seoul National University, Seoul, Korea
| | - Bin Xu
- Department of Orthopedic Surgery, College of Medicine, Seoul National University, Seoul, Korea
| | - Jae Hyup Lee
- Department of Orthopedic Surgery, College of Medicine, Seoul National University, Seoul, Korea.
- Department of Orthopaedic Surgery, College of Medicine, Seoul National University, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, 20 Boramaero 5-gil, Dongjak-gu, Seoul, 07061, Korea.
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Abstract
In this article, we tried to take stock of the state of the art in ultrasonic-assisted lipoplasty focusing on its most recent technologic advances and in the newest clinical applications, such as overweight, obesity, breast surgery and regenerative medicine. Great space was devoted to the analysis and clarification of the most common myths and legends related to this intriguing technique.
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Madelung's Disease: Lipectomy or Liposuction? BIOMED RESEARCH INTERNATIONAL 2018; 2018:3975974. [PMID: 29682541 PMCID: PMC5840946 DOI: 10.1155/2018/3975974] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 01/06/2018] [Accepted: 01/18/2018] [Indexed: 12/27/2022]
Abstract
Background Madelung's disease is a rare lipid metabolic disorder characterized by diffuse, uncapsulated lipomas in the neck, shoulder, and other areas. It mainly affects middle-aged men and is related to alcohol abuse, and the cause is not clear. Surgical treatments include lipectomy and liposuction. Methods This systematic review analyzed the treatment of Madelung's disease described in 52 articles including complete patient details, published between 2000 and 2015, and retrieved from the Web of Science, PubMed, Medline, and Embase. Results Lipectomy was performed in most cases and achieved more complete removal and better control of iatrogenic lesions of nearby structures than liposuction. Liposuction achieved good cosmetic results and is simpler and less invasive than lipectomy, but clinical experience is limited. Conclusions Both lipectomy and liposuction have advantages and drawbacks. Surgeons should base the choice of optimal treatment on patient characteristics. Novel surgical techniques and etiologically targeted treatments hold promise as future therapies.
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Gao Y, Hu JL, Zhang XX, Zhang MS, Lu Y. Madelung's Disease: Is Insobriety the Chief Cause? Aesthetic Plast Surg 2017; 41:1208-1216. [PMID: 28791470 DOI: 10.1007/s00266-017-0920-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Accepted: 06/07/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Madelung's disease (MD) is a rare disease of unknown etiology that is characterized by massive fatty deposits distributed in a symmetrical pattern mainly in the head, neck, and upper trunk. Here, we sought to explore the pathogeny and treatment of MD. METHODS We enrolled ten patients who underwent surgical operations and one patient who refused an operation at our hospital between January 2009 and December 2016. We collected their medical histories and the preoperative and postoperative serological indices. The serum chemistry clinical outcomes were compared between the preoperative and postoperative states. RESULTS The mean alcohol intake of the eleven patients exceeded 450 g daily. Ten patients underwent open excisions, and the other patient refused an operation. No significant differences were observed between the preoperative and postoperative serum chemistry results. No recurrence has yet been observed in any of the ten operated patients. CONCLUSIONS All of the patients in our study had associated alcoholism. Thus, insobriety might be one of the causes of MD. We believe that open operations may be an effective treatment based on the outcomes of the surgeries. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Yuan Gao
- Department of General Surgery, The Affiliated Hospital of Qingdao University, No. 1677 Wutaishan Road Huangdao District, Qingdao, 266555, Shandong, People's Republic of China
| | - Ji-Lin Hu
- Department of General Surgery, The Affiliated Hospital of Qingdao University, No. 1677 Wutaishan Road Huangdao District, Qingdao, 266555, Shandong, People's Republic of China
| | - Xian-Xiang Zhang
- Department of General Surgery, The Affiliated Hospital of Qingdao University, No. 1677 Wutaishan Road Huangdao District, Qingdao, 266555, Shandong, People's Republic of China
| | - Mao-Shen Zhang
- Department of General Surgery, The Affiliated Hospital of Qingdao University, No. 1677 Wutaishan Road Huangdao District, Qingdao, 266555, Shandong, People's Republic of China
| | - Yun Lu
- Department of General Surgery, The Affiliated Hospital of Qingdao University, No. 1677 Wutaishan Road Huangdao District, Qingdao, 266555, Shandong, People's Republic of China.
- Shandong Key Laboratory of Digital Medicine and Computer Assisted Surgery, Qingdao, People's Republic of China.
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Abstract
The abstract book contains the abstracts of keynote lectures, focus sessions, symposia, workshops, AIUC annual meeting, AISLEC annual meeting, EPUAP annual meeting, ETRS special session, sponsor symposia, oral presentations, poster presentations and the subject index.
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Re: Functional and Therapeutic Indications of Liposuction: Personal Experience and Review of the Literature. Ann Plast Surg 2016; 77:369-70. [PMID: 27404478 DOI: 10.1097/sap.0000000000000866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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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; 39:440-8. [PMID: 25860506 DOI: 10.1007/s00266-015-0478-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 03/16/2015] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Patients with syndromic causes of lipomatosis of the head and neck, although rare, often present late in the course of the disease in a myriad of ways, including concomitant airway obstruction, severe functional limitations, and/or significant cosmetic defects. The goal of this report was to review the literature and present a concise overview of the major syndromes causing lipomatosis of the head and neck. METHODS A literature search was performed to gather information on syndromic lipomatosis of the head and neck region. PubMed was searched for the following conditions: Familial multiple lipomatosis (FML), multiple symmetrical lipomatosis (MSL), congenital infiltrating lipomatosis of the face (CIL-F), and Nasopalpebral lipoma-coloboma syndrome (NLCS). Data gathered included results of surgical cases of the head and neck region. RESULTS A total of 48 reports comprising 172 cases of syndromic lipomatosis of the head and neck region were deemed eligible for review. Eighty-five percent of patients were male with an average age of 35 years. Seventy-four percent of cases appeared in the neck region, whereas 23 % presented in the face and scalp. 89 % of cases were treated with surgical excision, with 11 % of cases treated with liposuction. The most common complications were hematoma and seroma in MSL, recurrence in FML, neuropraxia in CIL-F, and mild telecanthus in NLCS. CONCLUSIONS Syndromic causes of lipomatosis are generally benign in nature but difficult to control long term. Because these conditions include frequent recurrence and subsequent difficulty in clearing the disease, the authors advocate early and aggressive surgical excision of syndromic lipomatosis. NO LEVEL ASSIGNED This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Kashyap Komarraju Tadisina
- Department of Plastic Surgery, Cleveland Clinic Lerner College of Medicine, 9500 Euclid Ave, Suite A60, Cleveland, OH, 44195, USA
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Enzi G, Busetto L, Sergi G, Coin A, Inelmen EM, Vindigni V, Bassetto F, Cinti S. Multiple symmetric lipomatosis: a rare disease and its possible links to brown adipose tissue. Nutr Metab Cardiovasc Dis 2015; 25:347-353. [PMID: 25770761 DOI: 10.1016/j.numecd.2015.01.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 01/28/2015] [Accepted: 01/28/2015] [Indexed: 02/06/2023]
Abstract
AIM Aim of this study is an updated review of our case series (72 patients) as well as available literature on the Multiple Symmetric Lipomatosis (MSL), a rare disease primarily involving adipose tissue, characterized by the presence of not encapsulated fat masses, symmetrically disposed at characteristic body sites (neck, trunk, proximal parts of upper and lower limbs). DATA SYNTHESIS The disease is more frequent in males, associated to an elevated chronic alcohol consumption, mainly in form of red wine. Familiarity has been reported and MSL is considered an autosomic dominant inherited disease. MSL is associated to severe clinical complications, represented by occupation of the mediastinum by lipomatous tissue with a mediastinal syndrome and by the presence of a somatic and autonomic neuropathies. Hyper-alphalipoproteinemia with an increased adipose tissue lipoprotein-lipase activity, a defect of adrenergic stimulated lipolysis and a reduction of mitochondrial enzymes have been described. The localization of lipomatous masses suggests that MSL lipomas could originate from brown adipose tissue (BAT). Moreover, studies on cultured pre-adipocytes demonstrate that these cells synthetize the mitochondrial inner membrane protein UCP-1, the selective marker of BAT. Surgical removal of lipomatous tissue is to date the only validated therapeutic approach. CONCLUSIONS MSL is supposed to be the result of a disorder of the proliferation and differentiation of human BAT cells.
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Affiliation(s)
- G Enzi
- Department of Medicine, University of Padua, Italy
| | - L Busetto
- Department of Medicine, University of Padua, Italy.
| | - G Sergi
- Department of Medicine, University of Padua, Italy
| | - A Coin
- Department of Medicine, University of Padua, Italy
| | - E M Inelmen
- Department of Medicine, University of Padua, Italy
| | - V Vindigni
- Institute of Plastic Surgery, University of Padua, Italy
| | - F Bassetto
- Institute of Plastic Surgery, University of Padua, Italy
| | - S Cinti
- Department of Experimental and Clinical Medicine & Diagnostic Electron Microscopy, United Hospitals, University of Ancona (Politecnico delle Marche), Italy
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Park KH, Hong YH, Choi SJ, Sung JJ, Lee KW. Multiple Symmetric Lipomatosis Presenting with Bilateral Brachial Plexopathy. J Clin Neurol 2015; 11:400-1. [PMID: 26256662 PMCID: PMC4596103 DOI: 10.3988/jcn.2015.11.4.400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 03/02/2015] [Accepted: 03/04/2015] [Indexed: 11/17/2022] Open
Affiliation(s)
- Kee Hong Park
- Department of Neurology, Seoul National University Hospital, Seoul, Korea
| | - Yoon-Ho Hong
- Department of Neurology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Seok-Jin Choi
- Department of Neurology, Seoul National University Hospital, Seoul, Korea
| | - Jung-Joon Sung
- Department of Neurology, Seoul National University Hospital, Seoul, Korea
| | - Kwang-Woo Lee
- Department of Neurology, Seoul National University Hospital, Seoul, Korea
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