Unusual presentation of Madelung's disease: case report
DOI:
https://doi.org/10.63688/2awsr520Keywords:
Madelung disease, multiple symmetric lipomatosis, lipectomy, adipose tissue, case reportAbstract
Introduction: Madelung disease (MD), also known as multiple symmetric lipomatosis, is a rare disorder characterized by progressive, diffuse, symmetric, unencapsulated deposits of mature adipose tissue. It predominantly affects middle-aged men and is frequently associated with chronic alcohol consumption. Its presentation in non-alcoholic women is exceptional and poses diagnostic challenges.
Methods: We report the case of a 44-year-old non-alcoholic woman with cervicothoracic adipose masses present for 28 years and accelerated growth since 2020. Evaluation included medical history, physical examination, laboratory tests, computed tomography, and histopathological analysis. Staged surgical debulking was performed, beginning with posterior cervical lipectomy, followed by outpatient clinical monitoring.
Results: Physical examination revealed multiple soft, mobile, painless cervicothoracic masses, including an approximately 20-cm upper interscapular lesion, associated with cosmetic deformity and local discomfort. Computed tomography demonstrated bilateral, symmetric, unencapsulated adipose tissue accumulations in the posterior and lateral cervical regions, supraclavicular fossae, and interscapular region, without destructive invasion. Histopathology confirmed unencapsulated mature adipose tissue arranged in lobules separated by thin fibrous septa, without atypia, lipoblasts, or necrosis. Three months after surgery, the cervicodorsal deformity had decreased.
Conclusions: MD should be considered in patients presenting with symmetric cervicothoracic adipose masses, including women without alcohol consumption. Clinical, radiological, and histopathological correlation enables diagnosis and guides treatment. Surgical debulking can improve deformity; however, prolonged follow-up is necessary because of the risk of recurrence.
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Copyright (c) 2026 Mario Gabriel Salas Martínez, Anthony Bryan Cevallos Falcones, Jorge Luis Guzmán León, Christian Abraham Orellana Franco, Erick Cristóbal Mora Yépez (Autor/a)
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