Yan YJ, Zhou SQ, Li CQ, Ruan Y. Diagnostic and surgical challenges of progressive neck and upper back painless masses in Madelung’s disease: A case report and review of literature. World J Clin Cases 2022; 10(1): 361-370 [PMID: 35071540 DOI: 10.12998/wjcc.v10.i1.361]
Corresponding Author of This Article
Chun-Qiao Li, MD, Attending Doctor, Department of Otorhinolaryngology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 16 Jichang Road, Baiyun District, Guangzhou 510405, Guangdong Province, China. lichunqiao18154920@163.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jan 7, 2022; 10(1): 361-370 Published online Jan 7, 2022. doi: 10.12998/wjcc.v10.i1.361
Diagnostic and surgical challenges of progressive neck and upper back painless masses in Madelung’s disease: A case report and review of literature
Ya-Jie Yan, Shi-Qing Zhou, Chun-Qiao Li, Yan Ruan
Ya-Jie Yan, Chun-Qiao Li, Yan Ruan, Department of Otorhinolaryngology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
Shi-Qing Zhou, Department of Experimental Research, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou 510075, Guangdong Province, China
Shi-Qing Zhou, Department of Otorhinolaryngology head and neck, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong Province, China
Author contributions: Yan YJ collected the clinical data, discussed the details, and contributed to writing the manuscript; Zhou SQ and Ruan Y contributed to the follow-up of the patient and modified the manuscript; Li CQ modified the manuscript and was a major contributor to writing the manuscript.
Supported bythe National Natural Science Foundation of China, No. 81974581; Basic and Applied Research Foundation of Guangdong Province, China, No. 2020A1515110407; Scientific Research Fund of Guangdong Provincial Bureau of Traditional Chinese Medicine China, No. 20211200.
Informed consent statement: Written informed consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised accordingly.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chun-Qiao Li, MD, Attending Doctor, Department of Otorhinolaryngology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 16 Jichang Road, Baiyun District, Guangzhou 510405, Guangdong Province, China. lichunqiao18154920@163.com
Received: August 19, 2021 Peer-review started: August 19, 2021 First decision: November 1, 2021 Revised: November 14, 2021 Accepted: December 3, 2021 Article in press: December 3, 2021 Published online: January 7, 2022 Processing time: 132 Days and 20.7 Hours
Abstract
BACKGROUND
Madelung’s disease (MD) is a chronic alcoholism-associated metabolic syndrome characterized by symmetrical subcutaneous deposition of adipose tissue in the head, neck, shoulders, back, trunk, and nerve roots of the upper and lower limbs. It is relatively rare in Asian individuals and is prone to misdiagnosis. Herein, we report a case of a patient with MD who had undergone surgical management at our hospital, and we discuss the pathogenesis, diagnosis, and treatment of MD.
CASE SUMMARY
We report a case of MD in a 65-year-old man of Han descent. The patient had multiple, painless progressive masses for more than five years in the neck and more than 30 years in the upper back. Because of neck mobility limitations and progressive cosmetic deformities caused by the masses, he was admitted to our hospital. He drank approximately 500 mL of liquor per day and smoked heavily for more than 30 years. Contrast-enhanced computed tomography of the neck and chest documented abundant unencapsulated, subcutaneous fatty deposits. We prepared a staged operation plan. The patient was diagnosed with MD; he was advised to abstain from alcohol and was followed up regularly. After a 3-month follow-up, no recurrence of fat accumulation was found in the surgical areas.
CONCLUSION
This report presents a case of surgical treatment for MD to improve clinicians' understanding of the disease.
Core Tip: Madelung’s disease (MD) is a rare chronic alcoholism-associated metabolic syndrome characterized by symmetrical deposition of adipose tissue subcutaneously in the head, neck, shoulders, back, trunk, and nerve roots of the upper and lower limbs. No consensus exists concerning the diagnosis, pathogenesis, and treatment of MD. Recently, a patient with MD accompanied by hypertension had undergone surgical resection and recovered well at our hospital. Herein, we present this case to improve clinicians’ diagnosis and treatment of MD while emphasizing the manifestations of MD presenting as head and neck masses.
