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Madelung’s Disease: Revision of 59 Surgical Cases

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Abstract

Background

Madelung’s disease (MD) is a rare disease, more common in Mediterranean countries and associated with alcohol abuse. However, MD etiology remains not completely understood.

Objective

The aim of this study was to investigate clinical features, treatment options and outcomes in patients with MD treated in our plastic surgery department.

Methods

We retrospectively reviewed 59 cases of MD operated on between 2004 and 2013. Demographic information, location of the deposits, associated pathology and habits, number and type of surgeries performed, surgical complications and disease evolution were analyzed.

Results

Ninety percent of the patients were males. Active or past history of alcohol abuse was reported by 86%. The main affected areas were anterior and posterior neck. A total of 230 surgical procedures were performed. Open surgery was used on 192 occasions (83.5%), liposuction alone on 30 procedures (13%) and lipectomy combined with liposuction on 8 interventions (3.5%). Surgical complications were found in 41 procedures (17.8%). Twenty-three patients (39%) were identified as having disease recurrence of the operated site in a mean time of 3.8 years. Alcohol consumption was not clearly associated with disease recurrence.

Conclusions

Demographic characteristics of the studied cohort stand for published data. It is our opinion that lipectomy/dermolipectomy provides better aesthetic and functional results. Lipectomy procedures allow a thorough excision, correct identification of noble structures and careful hemostasis. Liposuction techniques, even ultrasound-assisted ones, had limited efficacy for the treatment of large masses. A long follow-up period is recommended considering the high propensity and mean time to recurrence.

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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References

  1. Brodie B (1846) Clinical lectures on surgery delivered at St George’s Hospital. Lea & Blanchard, Philadelphia, p 275

    Google Scholar 

  2. Madelung O (1888) Ueber den Fetthals. Arch Klin Chir 37:106–130

    Google Scholar 

  3. Launois P, Bensaude R (1898) De l’adenolipomatose symetrique. Soc Med Hosp Paris Bull Mem 15:298–318

    Google Scholar 

  4. Ruzicka T, Vieluf D, Landthaler M, Braun-Falco O (1987) Benign symmetric lipomatosis Launois-Bensaude. Report of ten cases and review of the literature. J Am Acad Dermatol 17(4):663–674

    Article  CAS  PubMed  Google Scholar 

  5. González-García R, Rodríguez-Campo FJ, Sastre-Pérez J, Muñoz-Guerra MF (2004) Benign symmetric lipomatosis (Madelung’s disease): case reports and current management. Aesthet Plast Surg 28(2):108–112

    Article  Google Scholar 

  6. Jiménez Aragón F, Morales Puebla JM, Corzón Pereira T (2013) Madelung’s disease. Acta Otorrinolaringol Esp 64(2):166–167

    Article  PubMed  Google Scholar 

  7. Shetty C, Avinash KR, Auluck A, Mupparapu M (2007) Multiple symmetric lipomatosis (MSL) of neck in a child (Madelung’s disease): report of a rare presentation. Dentomaxillofac Radiol 36(1):51–54

    Article  CAS  PubMed  Google Scholar 

  8. Enzi G, Inelmen EM, Baritussio A, Dorigo P, Prosdocimi M, Mazzoleni F (1977) Multiple symmetric lipomatosis: a defect in adrenergic-stimulated lipolysis. J Clin Invest 60(6):1221–1229

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Plummer C, Spring PJ, Marotta R, Chin J, Taylor G, Sharpe D, Athanasou NA, Thyagarajan D, Berkovic SF (2013) Multiple symmetrical lipomatosis—a mitochondrial disorder of brown fat. Mitochondrion 13(4):269–276

    Article  CAS  PubMed  Google Scholar 

  10. Brea-García B, Cameselle-Teijeiro J, Couto-González I, Taboada-Suárez A, González-Álvarez E (2013) Madelung’s disease: comorbidities, fatty mass distribution, and response to treatment of 22 patients. Aesthet Plast Surg 37(2):409–416

    Article  Google Scholar 

  11. Ardeleanu V, Chicos S, Georgescu C, Tutunaru D (2013) Multiple benign symmetric lipomatosis—a differential diagnosis of obesity. Chirurgia (Bucur) 108(4):580–583

    CAS  Google Scholar 

  12. Heike Z, Gudrun U-M, Frank RD, Vetter H, Walger P (2008) Multiple benign symmetric lipomatosis—a differential diagnosis of obesity: is there a rationale for fibrate treatment? Obes Surg 18(2):240–242

    Article  PubMed  Google Scholar 

  13. Meningaud J-P, Pitak-Arnnop P, Bertrand J-C (2007) Multiple symmetric lipomatosis: case report and review of the literature. J Oral Maxillofac Surg 65(7):1365–1369

    Article  PubMed  Google Scholar 

  14. Enzi G, Busetto L, Ceschin E, Coin A, Digito M, Pigozzo S (2002) Multiple symmetric lipomatosis: clinical aspects and outcome in a long-term longitudinal study. Int J Obes Relat Metab Disord 26(2):253–261

    Article  CAS  PubMed  Google Scholar 

  15. Donhauser G, Vieluf D, Ruzicka T, Braun-Falco O (1991) Benign symmetric Launois-Bensaude type III lipomatosis and Bureau-Barrière syndrome. Der Hautarzt; Zeitschrift für Dermatologie, Venerol und verwandte Gebiete 42(5):311–314

    CAS  Google Scholar 

  16. Leung NW, Gaer J, Beggs D, Kark AE, Holloway B, Peters TJ (1987) Multiple symmetric lipomatosis (Launois-Bensaude syndrome): effect of oral salbutamol. Clin Endocrinol (Oxf) 27(5):601–606

    Article  CAS  Google Scholar 

  17. Saiz Hervás E, Martín Llorens M, LópezAlvarez J (2000) Peripheral neuropathy as the first manifestation of Madelung’s disease. Br J Dermatol 143(3):684–686

    Article  PubMed  Google Scholar 

  18. Lemaire O, Paul C, Zabraniecki L (2008) Distal Madelung-Launois-Bensaude disease: an unusual differential diagnosis of acromelic arthritis. Clin Exp Rheumatol 26(2):351–353

    CAS  PubMed  Google Scholar 

  19. Laure B, Sury F, Tayeb T, Corre P, Goga D (2011) Launois-Bensaude syndrome involving the orbits. J Craniomaxillofac Surg 39(1):21–23

    Article  PubMed  Google Scholar 

  20. Lopez-Ceres A, Aguilar-Lizarralde Y, Villalobos Sánchez A, Prieto Sánchez E, Valiente Alvarez A (2006) Benign symmetric lipomatosis of the tongue in Madelung’s disease. J Craniomaxillofac Surg 34(8):489–493

    Article  PubMed  Google Scholar 

  21. Ramos S, Pinheiro S, Diogo C, Cabral L, Cruzeiro C (2010) Madelung disease: a not-so-rare disorder. Ann Plast Surg 64(1):122–124

    Article  CAS  PubMed  Google Scholar 

  22. Faga A, Valdatta LA, Thione A, Buoro M (2001) Ultrasound assisted liposuction for the palliative treatment of Madelung’s disease: a case report. Aesthet Plast Surg 25(3):181–183

    Article  CAS  Google Scholar 

  23. Ujpál M, Németh ZS, Reichwein A, Szabó GY (2001) Long-term results following surgical treatment of benign symmetric lipomatosis (BSL). Int J Oral Maxillofac Surg 30(6):479–483

    Article  PubMed  Google Scholar 

  24. Tremp M, Wettstein R, Tchang LA, Schaefer DJ, Rieger UM, Kalbermatten DF (2015) Power-assisted liposuction (PAL) of multiple symmetric lipomatosis (MSL)—a longitudinal study. Surg Obes Relat Dis 11(1):155–160

    Article  PubMed  Google Scholar 

  25. Wong DSY, Lam LK, Chung JHP, Ng RWM, Li GKH, Chan VSH (2003) Aesthetic considerations in the cervicofacial management of Madelung syndrome. Scand J Plast Reconstr Surg Hand Surg 37(1):34–40

    Article  PubMed  Google Scholar 

  26. Hundeshagen G, Hundeshagen G, Assadov KF, Podmelle F (2014) Facelift- and circum-occipital incision placement for fat extirpation of the neck in Madelung’s disease—a two-case report. J Craniomaxillofac Surg 42(2):175–179

    Article  PubMed  Google Scholar 

  27. Zhang W-J, Jiang H, Zhang J-L, Zhang Y-F, Yi J, Liao J-C, Zhao Y-Z (2011) Surgical treatment of multiple symmetric lipomatosis (Madelung’s disease): a single-center experience. J Oral Maxillofac Surg 69(9):2448–2451

    Article  PubMed  Google Scholar 

  28. Tizian C, Berger A, Vykoupil KF (1983) Malignant degeneration in Madelung’s disease (benign lipomatosis of the neck): case report. Br J Plast Surg 36(2):187–189

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Hospital da Prelada, Rua de Sarmento de Beires, 153, 4250-449, Porto, Portugal

    Cristina Isabel Calvo Pinto, Pedro João Marques Cardoso Carvalho & Manuel Maia Oliveira Correia

Authors
  1. Cristina Isabel Calvo Pinto
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  2. Pedro João Marques Cardoso Carvalho
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  3. Manuel Maia Oliveira Correia
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Correspondence to Cristina Isabel Calvo Pinto.

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Pinto, C.I.C., Carvalho, P.J.M.C. & Correia, M.M.O. Madelung’s Disease: Revision of 59 Surgical Cases. Aesth Plast Surg 41, 359–368 (2017). https://doi.org/10.1007/s00266-016-0759-x

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  • DOI: https://doi.org/10.1007/s00266-016-0759-x

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