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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
PubMed
Summary
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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.

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  • 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.