Tuberc Respir Dis.  2011 Jan;70(1):63-68.

A Case of Multiple Symmetrical Lipomatosis Causing Upper Airway Obstruction

• Kim JK
• Kim KC

Abstract

Multiple symmetrical lipomatosis (MSL), also called Madelung's disease, is a rare disorder of unknown etiology and characterized by abnormal accumulation of large subcutaneous fatty masses in neck, shoulder, and upper trunk. MSL has known to predominantly affect middle-aged men with a history of alcoholism. Although the clinical course of MSL is considered to be slowly progressive, in advanced stage, fatty masses in the neck may compress the upper aerodigestive tract, resulting in dyspnea and dysphagia. The treatment of MSL is surgical resection, but radical excision is very difficult and recurrence after surgery is frequent. We report the case of 55-year-old man with long lasting MSL, which caused severe airway obstruction. This patient was admitted with progressive dyspnea and massive accumulation of fat around the vocal cord that was detected on a neck CT scan. This abnormal fatty infiltration in supraglottic region caused upper airway obstruction.

Keyword

Lipomatosis, Multiple Symmetrical; Airway Obstruction

MeSH Terms

Airway Obstruction
Alcoholism
Deglutition Disorders
Dyspnea
Humans
Lipomatosis, Multiple Symmetrical
Male
Middle Aged
Neck
Recurrence
Shoulder
Vocal Cords

Figure

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  Figure 1 Anterior (A) and lateral (B) view of the patient show multiple, symmetric subcutaneous fatty masses in neck, shoulder and upper trunk.

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  Figure 2 (A) Chest AP shows widening of superior mediastinum. (B) Chest CT shows compression and displacement of the trachea by surrounding fat infiltration in mediastinum and bilateral pleural effusions.

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  Figure 3 Serial computed tomography scans of the neck show abnormal fat accumulation around vocal cord and massive fat infiltration in neck region.

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  Figure 4 Bronchoscopy shows tense swelling in supraglottic region (A) and false vocal cord (B).

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