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[Benign symmetrical lipomatosis]
E J Houwerzijl1, T W van den Akker, J D Gökemeijer
1Afd. Interne Geneeskunde, Martini Ziekenhuis, locatie Van Swieten, Groningen.
Nederlands Tijdschrift Voor Geneeskunde
|March 5, 1999
Summary
This case report highlights a rare association between benign symmetrical lipomatosis and upper abdominal adenocarcinoma. Autopsy revealed extensive cancer, suggesting a potential link between these conditions in middle-aged men.
Area of Science:
- Internal Medicine
- Oncology
- Pathology
Background:
- Benign symmetrical lipomatosis (Madelung's disease) is a rare condition characterized by non-encapsulated adipose tissue accumulation, typically in middle-aged men.
- The exact pathogenesis of Madelung's disease remains unknown, but associations with alcohol abuse, metabolic disorders, and neurological conditions have been reported.
Observation:
- A 51-year-old male presented with a 3-month history of malaise, epigastric pain, nausea, vomiting, and constipation.
- The patient exhibited a pseudo-athletic appearance due to symmetrical fat deposits on the trunk, back, shoulders, and proximal extremities, consistent with benign symmetrical lipomatosis.
Findings:
- The patient died from embolism of the aortic bifurcation.
- Autopsy revealed an extensive adenocarcinoma in the upper abdomen, likely originating from the pancreas or stomach.
- This finding suggests a potential, albeit rare, association between benign symmetrical lipomatosis and upper abdominal malignancies.
Implications:
- This case underscores the importance of considering underlying malignancies in patients with benign symmetrical lipomatosis, particularly when presenting with constitutional symptoms.
- Further research into the pathogenesis of Madelung's disease may elucidate potential shared pathways or risk factors with certain cancers.
- Early detection and management of associated conditions are crucial for improving patient outcomes.