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Tosunoğlu B, Altıkardeş M, Arık EP, Kaya N, İnan LE. Could Madelung disease be a cause of stroke? A rare case report. Folia Med (Plovdiv) 2024; 66:583-586. [PMID: 39257262 DOI: 10.3897/folmed.66.e116329] [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] [Received: 11/26/2023] [Accepted: 03/14/2024] [Indexed: 09/12/2024] Open
Abstract
Multiple symmetric lipomatosis (MLS), also known as Launois-Bensaude syndrome or Madelung disease, is a rare metabolic condition characterized by generally symmetrical, non-encapsulated fat accumulations in the patient's body.
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Affiliation(s)
| | | | | | - Nilay Kaya
- Ankara Training and Research Hospital, Ankara, Turkiye
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2
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Lee BH, Lee YM, Park SO, Chang LS, Kim YH. A Case Report of Madelung's Disease. Arch Plast Surg 2023; 50:463-467. [PMID: 37808325 PMCID: PMC10556315 DOI: 10.1055/a-2122-6121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 06/30/2023] [Indexed: 10/10/2023] Open
Abstract
Madelung's disease (MD) is a rare disease characterized by diffuse, nonencapsulated, multiple fat masses in different areas of the body. In this case report, we present a case of MD in Asia and its management. A 66-year-old man with a history of hypertension presented with massive growth of soft tissue around the neck, breasts, upper back, and lower abdomen. Preoperative magnetic resonance imaging revealed remarkably hypertrophic fat tissue around the neck and anterior chest was wall, which consistent with the diagnosis of MD. Multiple linear incisions were made on the neck and 763, 186, 635 g of posterior, right, and left fat tissues were excised, respectively. A single wide, transverse incision was done to excise 1,072 g of fat from the upper back. Masses of both breasts were excised, preserving the inferior pedicle, weighing 1,086 (right) and 1,164 g (left). The recovery was optimal and the patient was discharged without complications. In this case, we excised the adipose masses as much as possible and improved contour and symmetry. However, the fat infiltrations in the patient were diffusely distributed, making total fat excision difficult. This rare case report may help in managing patients with MD.
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Affiliation(s)
- Bo Hyun Lee
- Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Young Mann Lee
- Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Seong Oh Park
- Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Lan Sook Chang
- Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Youn Hawn Kim
- Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Republic of Korea
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3
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Wang CJ, Noble PB, Elliot JG, James AL, Wang KCW. From Beneath the Skin to the Airway Wall: Understanding the Pathological Role of Adipose Tissue in Comorbid Asthma-Obesity. Compr Physiol 2023; 13:4321-4353. [PMID: 36715283 DOI: 10.1002/cphy.c220011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
This article provides a contemporary report on the role of adipose tissue in respiratory dysfunction. Adipose tissue is distributed throughout the body, accumulating beneath the skin (subcutaneous), around organs (visceral), and importantly in the context of respiratory disease, has recently been shown to accumulate within the airway wall: "airway-associated adipose tissue." Excessive adipose tissue deposition compromises respiratory function and increases the severity of diseases such as asthma. The mechanisms of respiratory impairment are inflammatory, structural, and mechanical in nature, vary depending on the anatomical site of deposition and adipose tissue subtype, and likely contribute to different phenotypes of comorbid asthma-obesity. An understanding of adipose tissue-driven pathophysiology provides an opportunity for diagnostic advancement and patient-specific treatment. As an exemplar, the potential impact of airway-associated adipose tissue is highlighted, and how this may change the management of a patient with asthma who is also obese. © 2023 American Physiological Society. Compr Physiol 13:4321-4353, 2023.
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Affiliation(s)
- Carolyn J Wang
- School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Peter B Noble
- School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - John G Elliot
- School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia.,Department of Pulmonary Physiology and Sleep Medicine, West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Alan L James
- Department of Pulmonary Physiology and Sleep Medicine, West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.,Medical School, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Kimberley C W Wang
- School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia.,Telethon Kids Institute, The University of Western Australia, Nedlands, Western Australia, Australia
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Caponnetto F, Manini I, Bulfoni M, Zingaretti N, Miotti G, Di Loreto C, Cesselli D, Mariuzzi L, Parodi PC. Human Adipose-Derived Stem Cells in Madelung's Disease: Morphological and Functional Characterization. Cells 2020; 10:cells10010044. [PMID: 33396896 PMCID: PMC7824042 DOI: 10.3390/cells10010044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/21/2020] [Accepted: 12/28/2020] [Indexed: 12/17/2022] Open
Abstract
Madelung Disease (MD) is a syndrome characterized by the accumulation of aberrant symmetric adipose tissue deposits. The etiology of this disease is yet to be elucidated, even though the presence of comorbidities, either genetic or environmental, has been reported. For this reason, establishing an in vitro model for MD is considered crucial to get insights into its physiopathology. We previously established a protocol for isolation and culture of stem cells from diseased tissues. Therefore, we isolated human adipose-derived stem cells (ASC) from MD patients and compared these cells with those isolated from healthy subjects in terms of surface phenotype, growth kinetic, adipogenic differentiation potential, and molecular alterations. Moreover, we evaluated the ability of the MD-ASC secretome to affect healthy ASC. The results reported a difference in the growth kinetic and surface markers of MD-ASC compared to healthy ASC but not in adipogenic differentiation. The most commonly described mitochondrial mutations were not observed. Still, MD-ASC secretome was able to shift the healthy ASC phenotype to an MD phenotype. This work provides evidence of the possibility of exploiting a patient-based in vitro model for better understanding MD pathophysiology, possibly favoring the development of novel target therapies.
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Affiliation(s)
- Federica Caponnetto
- Department of Medicine, University of Udine, 33100 Udine, Italy; (M.B.); (C.D.L.); (D.C.); (L.M.); (P.C.P.)
- Correspondence: ; Tel.: +39-04-3255-9412
| | - Ivana Manini
- Institute of Pathology, University Hospital of Udine, 33100 Udine, Italy;
| | - Michela Bulfoni
- Department of Medicine, University of Udine, 33100 Udine, Italy; (M.B.); (C.D.L.); (D.C.); (L.M.); (P.C.P.)
| | - Nicola Zingaretti
- Department of Medical Area (DAME), Clinic of Plastic and Reconstructive Surgery, Academic Hospital of Udine, University of Udine, 33100 Udine, Italy; (N.Z.); (G.M.)
| | - Giovanni Miotti
- Department of Medical Area (DAME), Clinic of Plastic and Reconstructive Surgery, Academic Hospital of Udine, University of Udine, 33100 Udine, Italy; (N.Z.); (G.M.)
| | - Carla Di Loreto
- Department of Medicine, University of Udine, 33100 Udine, Italy; (M.B.); (C.D.L.); (D.C.); (L.M.); (P.C.P.)
- Institute of Pathology, University Hospital of Udine, 33100 Udine, Italy;
| | - Daniela Cesselli
- Department of Medicine, University of Udine, 33100 Udine, Italy; (M.B.); (C.D.L.); (D.C.); (L.M.); (P.C.P.)
- Institute of Pathology, University Hospital of Udine, 33100 Udine, Italy;
| | - Laura Mariuzzi
- Department of Medicine, University of Udine, 33100 Udine, Italy; (M.B.); (C.D.L.); (D.C.); (L.M.); (P.C.P.)
- Institute of Pathology, University Hospital of Udine, 33100 Udine, Italy;
| | - Pier Camillo Parodi
- Department of Medicine, University of Udine, 33100 Udine, Italy; (M.B.); (C.D.L.); (D.C.); (L.M.); (P.C.P.)
- Department of Medical Area (DAME), Clinic of Plastic and Reconstructive Surgery, Academic Hospital of Udine, University of Udine, 33100 Udine, Italy; (N.Z.); (G.M.)
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Hoxha M, Cakoni R, Basho M. Rapidly progressive case of type I Madelung disease with bilateral parotid and minor salivary glands involvement. Br J Biomed Sci 2019; 77:48-52. [DOI: 10.1080/09674845.2019.1656497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- M Hoxha
- Department of Allergology, ‘Mother Teresa’ UHC, Tirane, Albania
| | - R Cakoni
- Department of Endocrinology, ‘Mother Teresa’ UHC, Tirane, Albania
| | - M Basho
- Department of Radiology, ‘Mother Teresa’ UHC, Tirane, Albania
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Szewc M, Sitarz R, Moroz N, Maciejewski R, Wierzbicki R. Madelung's disease - progressive, excessive, and symmetrical deposition of adipose tissue in the subcutaneous layer: case report and literature review. Diabetes Metab Syndr Obes 2018; 11:819-825. [PMID: 30538518 PMCID: PMC6263218 DOI: 10.2147/dmso.s181154] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Madelung's disease is a rare disorder described for the first time in the year 1846 by Brodie. It is characterized by the occurrence of progressive, excessive, and symmetrical deposits of adipose tissue in the subcutaneous layer. Most often, these changes concern the neck, the nape of the neck, arms, and upper back, giving the patients a specific, pseudoathletic appearance. Madelung's disease is also known as multiple symmetrical lipomatosis, benign symmetrical lipomatosis, and Launois-Bensaude syndrome. The most commonly affected ones are men who drink alcohol in excessive amounts. The fat masses emerging in the course of the disease are painless but can lead to adverse repercussions. Patients may experience dysphagia, dysphonia, difficulty in breathing, and limited mobility of the neck. The reasons for the willingness to take up treatment are also often esthetic reasons. The disease is usually accompanied by numerous metabolic disorders. The etiology of the disease has not been sufficiently explained so far, which creates diagnostic and therapeutic difficulties. Currently used treatment is limited to surgical resection of the resulting lesions or liposuction. Unfortunately, the effectiveness of these activities is limited. Most patients experience recurrence after treatment. This paper discusses the essence of Madelung's disease, numerous aspects of etiology, the manner of diagnosis, and treatment based on current literature data.
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Affiliation(s)
- Monika Szewc
- Department of Human Anatomy, Medical University of Lublin, Lublin, Poland
| | - Robert Sitarz
- Department of Human Anatomy, Medical University of Lublin, Lublin, Poland
- Department of Surgery with Trauma, Orthopaedic and Urological Subunit, Independent Public Health Care Center of the Ministry of Interior and Administration in Lublin, Lublin, Poland,
- Department of Surgery, St John's Cancer Center, Lublin, Poland
| | - Nina Moroz
- Department of Surgery with Trauma, Orthopaedic and Urological Subunit, Independent Public Health Care Center of the Ministry of Interior and Administration in Lublin, Lublin, Poland,
| | | | - Ryszard Wierzbicki
- Department of Surgery with Trauma, Orthopaedic and Urological Subunit, Independent Public Health Care Center of the Ministry of Interior and Administration in Lublin, Lublin, Poland,
- Department of Surgical Oncology, Medical University of Lublin, Lublin, Poland,
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Madelung’s disease: case series and literature review. ACTA MEDICA MARTINIANA 2018. [DOI: 10.2478/acm-2018-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Madelung’s disease also called benign symmetric lipomatosis is a rare disorder of unknown etiology. The disease affects almost exclusively middle-aged men with a history of multi-year alcohol abuse. The major symptom is presence of non-encapsulated benign fat masses, especially in the area of the head and neck. Limited head and neck movement, dysphagia, and dyspnea may appear as well.
The diagnosis is clinical and is supported by imaging methods, often elevated hepatic enzymes in blood serum, and histological examination with finding of mature adipose tissue without signs of proliferation. Therapeutic methods involve liposuction or excision which is a method of choice nowadays.
In this article the authors review current knowledge, research state, and present five cases of the Madelung’s disease occurring within the last 10 years at the Clinic of Otorhinolaryngology and Head and Neck Surgery in Martin, Slovakia.
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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: 17] [Impact Index Per Article: 2.8] [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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