Madelung disease is a rare benign condition characterized by symmetrical growth of lipomas around the shoulders, neck, upper arms +/- upper trunk in peoples ages 30-60 years. Some may experience rapid growth of fatty deposits over a small course of months, and others may experience a slower progression over years. It most often affects men of Mediterranean descent who have a history of alcohol abuse. Non-alcoholics and women may also be affected. The exact cause of this disease is unknown, but there may be a strong correction alcoholism since roughly 90% of those affected by Madelung have a history of alcohol abuse. The body’s inability to properly metabolize fat, may be suggestive of an endocrine disorder.
Like any other disease, signs and symptoms vary person to person with Madelung disease. A strong indication is the discovery of lipomas found on the left side of the body before the right. These masses are highly vascular with a rubbery consistency. The progression of fatty tissue around the shoulders and neck can lead to excruciating pain and a decrease in mobility. Those with Madelung disease may also develop peripheral neuropathy and neurological disturbances such as difficulty swallowing, hoarseness, sleep disturbances, a fluctuation in heart rate as well as blood pressure, and shortness of breath.
Madelung disease is diagnosed based on a thorough physical exam and history. Imaging studies such as computed tomography (CT scan) and/or magnetic resonance imaging (MRI) also prove to be helpful. A MRI scan is a preferred method for it aids in visualization of the lipomas and surround tissues. In some cases, a biopsy is needed to confirm diagnosis.
To date, the most effective treatment for Madelung disease is surgical excision and/or liposuction of lipomas. The limitation of liposuction is incomplete removal of lipoma. The main disadvantage of excision of lipomas is scarring, however it offers extensive reduction of the tumor. There is modest success in treating this condition with the medication, Salbutamol, which breaks down fats.
It is important abstain from alcohol intakes, improve diet which encourages weight loss, and correction of any associated endocrine abnormalities.
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