Systemic Benign Lipomatosis (Madelung’s Disease): Experience of Surgical Treatment. Clinical Case

Introduction. Diffuse symmetric lipomatosis (Madelung’s disease) is a rare and poorly understood disorder. This condition is characterized by diffuse proliferation of adipose tissue, leading to significant functional and aesthetic impairments. The documentation of clinical cases is essential to improve understanding of this pathology and formulate efficacious therapeutic strategies relevant to general practitioners, oncologists, otolaryngologists, neurologists, and thoracic surgeons. Aim. This study reports the findings from clinical observation in a 63-year-old patient with diffuse symmetric lipomatosis involving the neck, with intermuscular infiltration and compression of upper airways. We present an example of surgical management and subsequent follow-up care for such patients. Materials and methods. This article reports the treatment outcome of a 63-year-old male patient with substantial diffuse proliferation of adipose tissue in the neck region. The clinical, instrumental, and laboratory investigations included magnetic resonance imaging (MRI), fiberoptic bronchoscopy, fiberoptic laryngoscopy, fiberoptic gastroduodenoscopy, and fine-needle aspiration biopsy (FNAB). The surgical intervention involved open lipectomy with subsequent histopathological examination of the resected tissue. Results and discussion. The patient initially presented with substantial diffuse proliferation of adipose tissue affecting neck mobility and inducing symptoms related to airway compression. MRI revealed systemic benign lipomatosis, without significant cervical or mediastinal lymphadenopathy. The surgical intervention involved the removal of 1,800 grams of adipose tissue through an open lipectomy. In the postoperative period, the patient reported significant improvements in breathing, enhanced neck mobility, and a satisfactory cosmetic effect. However, disease recurrence was observed three years after surgery. Conclusion. This case report confirms the efficacy of open lipectomy as a treatment option for Madelung’s disease, particularly for relieving airway compression symptoms. However, the high risk of recurrence underscores the need for further investigation to formulate long-term management strategies for this condition.

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