[Benign symmetric lipomatosis: a symptom of alcoholic liver disease?]

Benign symmetric lipomatosis (BSL) leads to characteristic multiple lipomas of the neck and submandibular region. BSL is easily diagnosed by its typical feature, "Madelung's neck". However, the early stages are often missed or lead to futile diagnostic endeavours. A report is presented on 7 men with BSL aged 36--65 years who were investigated with regard to alcohol consumption, clinical findings and liver histology. This is the first time that liver histology has been systematically worked up in patients with BSL. All admitted long standing ethanol intake (x = 111 ml/day) prior to the development of BSL. The growth of the lipomas was irregular and occurred over a period of months. There was no correlation with overweight or hyperlipidemia. However, liver biopsy revealed features consistent with alcoholic liver disease in all subjects. It is suggested that BSL is a symptom of alcoholic liver disease mainly affecting middle-aged men.