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Madelung’s Disease: Comorbidities, Fatty Mass Distribution, and Response to Treatment of 22 Patients

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Madelung’s disease (MD) is an uncommon pathology characterized by the presence of multiple masses of unencapsulated adipose tissue that is symmetrically distributed. The aim of this study was to investigate clinical and epidemiological features of patients diagnosed with MD in our department. Associated diseases and evolution after treatment were also investigated.


We reviewed the clinical histories of 22 patients diagnosed with MD from 1990 to 2010 and obtained their epidemiological and clinical characteristics.


We found 21 patients with MD type 1 and one patient with MD type 2 according to Enzi’s classification. All patients were male, 95.5% with high alcohol intake, and 59.1% with some hepatic disease. No family antecedents were significant; 40.9% had dyslipidemia, 22.7% arterial hypertension, 22.7% chronic obstructive pulmonary disease (COPD), 13.6% hyperuricemia, 9.1% hypothyroidism, 4.5% diabetes mellitus type 2, and 4.5% carbohydrate intolerance; 40.9% had a body mass index >30, and 27.3% presented gynecomastia/lipomastia. The region most frequently affected by fatty deposits was the neck.


Madelung’s disease affects mainly alcoholic males in their fourth decade of life. Hepatic diseases appear in most patients. Also associated with MD are high lipid blood levels, arterial hypertension, COPD, hyperuricemia, and obesity. MD type 1 is the most frequent phenotype and the neck the most common location for fatty masses. Recurrence after surgery, in the same location or different locations, is a frequent event, even in patients who later abstain from alcohol intake.

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  1. Enzi G (1984) Multiple symmetric lipomatosis: an updated clinical report. Medicine (Baltimore) 63(212):56–64

    CAS  Google Scholar 

  2. Brodie BC (1846) Clinical lectures on surgery delivered at St. George’s Hospital. Lea & Blanchard, Philadelphia, pp 201–210

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

    Google Scholar 

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

    Google Scholar 

  5. Kratz C, Lenard HG, Ruzicka T, Gärtner J (2000) Multiple symmetric lipomatosis: an unusual cause of childhood obesity and mental retardation. Eur J Paediatr Neurol 4(2):63–67

    Article  PubMed  CAS  Google Scholar 

  6. 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  PubMed  CAS  Google Scholar 

  7. Ahuja AT, King AD, Chan ES, Kew J, Lam WW, Sun PM, King W, Metreweli C (1998) Madelung disease: distribution of cervical fat and preoperative findings at sonography, MR, and CT. AJNR Am J Neuroradiol 19(4):707–710

    PubMed  CAS  Google Scholar 

  8. Iglesias L, Pérez-Llantada E, Saro G, Pino M, Hernández JL (2000) Benign symmetric lipomatosis (Madelung’s disease). Eur J Intern Med 11(3):171–173

    Article  PubMed  Google Scholar 

  9. Semenou D, Coeugniet E, Segard M, Martinot-Duquennoy V, Delaporte E (2008) Launois-Bensaude’s disease: report of 17 cases. Ann Chir Plast Esthet 53(5):399–407

    Article  PubMed  CAS  Google Scholar 

  10. Kobayashi J, Nagao M, Miyamoto K, Matsubara S (2010) MERRF syndrome presenting with multiple symmetric lipomatosis in a Japanese patient. Intern Med 49(5):479–482

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  12. Enzi G, Biondetti PR, Fiore D, Mazzoleni F (1982) Computed tomography of deep fat masses in multiple symmetrical lipomatosis. Radiology 144(1):121–124

    PubMed  CAS  Google Scholar 

  13. John DG, Fung HK, van Hasselt CA, King WW (1992) Multiple symmetrical lipomatosis in the neck. Eur Arch Otorhinolaryngol 249(5):277–278

    Article  PubMed  CAS  Google Scholar 

  14. Lee HW, Kim TH, Cho JW, Ryu BY, Kim HK, Choi CS (2003) Multiple symmetric lipomatosis: Korean experience. Dermatol Surg 29(3):235–240

    Article  PubMed  Google Scholar 

  15. 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  PubMed  CAS  Google Scholar 

  16. Hansson E, Svensson H, Brorson H (2011) Liposuction may reduce pain in Dercum’s disease (adiposis dolorosa). Pain Med 12(6):942–952

    Article  PubMed  Google Scholar 

  17. Bornhövd E, Sakrauski AK, Brühl H, Walli R, Plewig G, Röcken M (2000) Multiple circumscribed subcutaneous lipomas associated with use of human immunodeficiency virus protease inhibitors? Br J Dermatol 143(5):1113–1114

    Article  PubMed  Google Scholar 

  18. Klopstock T, Naumann M, Schalke B, Bischof F, Seibel P, Kottlors M, Eckert P, Reiners K, Toyka KV, Reichmann H (1994) Multiple symmetric lipomatosis: abnormalities in complex IV and multiple deletions in mitochondrial DNA. Neurology 44(5):862–866

    Article  PubMed  CAS  Google Scholar 

  19. Payne CE (2000) Hereditary Madelung’s disease. J R Soc Med 93(4):194–195

    PubMed  CAS  Google Scholar 

  20. Chalk CH, Mills KR, Jacobs JM, Donaghy M (1990) Familial multiple symmetric lipomatosis with peripheral neuropathy. Neurology 40(8):1246–1250

    Article  PubMed  CAS  Google Scholar 

  21. Kodish ME, Alsever RN, Block MB (1974) Benign symmetric lipomatosis: functional sympathetic denervation of adipose tissue and possible hypertrophy of brown fat. Metabolism 23(10):937–945

    Article  PubMed  CAS  Google Scholar 

  22. Zancanaro C, Sbarbati A, Morroni M, Carraro R, Cigolini M, Enzi G, Cinti S (1990) Multiple symmetric lipomatosis. Ultrastructural investigation of the tissue and preadipocytes in primary culture. Lab Invest 63(2):253–258

    PubMed  CAS  Google Scholar 

  23. Weiss SW, Goldblum JR (2001) Benign lipomatous tumors. In: Enzinger and Weiss’s soft tissue tumors, 4th edn. Mosby, St. Louis, pp 571–637

  24. 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 

  25. Vilà MR, Gámez J, Solano A, Playán A, Schwartz S, Santorelli FM, Cervera C, Casali C, Montoya J, Villarroya F (2000) Uncoupling protein-1 mRNA expression in lipomas from patients bearing pathogenic mitochondrial DNA mutations. Biochem Biophys Res Commun 278(3):800–802

    Article  PubMed  Google Scholar 

  26. Donhauser G, Vieluf D, Ruzicka T, Braun-Falco O (1991) Benign symmetric Launois-Bensaude type III lipomatosis and Bureau–Barrière syndrome. Hautarzt 42(5):311–314

    PubMed  CAS  Google Scholar 

  27. Vargas-Díez E, Daudén E, Jones-Caballero M, García-Díez A (2000) Madelung’s disease involving the tongue. J Am Acad Dermatol 42(3):511–513

    Article  PubMed  Google Scholar 

  28. Poggi G, Moro G, Teragni C, Delmonte A, Saini G, Bernardo G (2006) Scrotal involvement in Madelung disease: clinical, ultrasound and MR findings. Abdom Imaging 31(4):503–505

    Article  PubMed  CAS  Google Scholar 

  29. Heike Z, Gudrun UM, 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 

  30. Basse P, Lohman M, Hovgaard C, Alsbjørn B (1991) Multiple symmetric lipomatosis. Acta Chir Plast 33(4):204–209

    PubMed  CAS  Google Scholar 

  31. Martínez-Escribano JA, Gonzalez R, Quecedo E, Febrer I (1999) Efficacy of lipectomy and liposuction in the treatment of multiple symmetric lipomatosis. Int J Dermatol 38(7):551–554

    Article  PubMed  Google Scholar 

  32. 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 

  33. Constantinidis J, Steinhart H, Zenk J, Bohlender J, Iro H (2003) Surgical therapy of Madelung’s disease in the head and neck area. HNO 51(3):216–220

    Article  PubMed  CAS  Google Scholar 

  34. Uglesić V, Knezević P, Milić M, Jokić D, Kosutić D (2004) Madelung syndrome (benign lipomatosis): clinical course and treatment. Scand J Plast Reconstr Surg Hand Surg 38(4):240–243

    Article  PubMed  Google Scholar 

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Correspondence to Ivan Couto-González.

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Brea-García, B., Cameselle-Teijeiro, J., Couto-González, I. et al. Madelung’s Disease: Comorbidities, Fatty Mass Distribution, and Response to Treatment of 22 Patients. Aesth Plast Surg 37, 409–416 (2013).

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  • Madelung’s disease
  • Lipomatosis
  • Alcohol abuse
  • Hepatic disease