A case of benign symmetrical lipomatosis in a patient with a chief complaint of a mass of the neck

Benign symmetrical lipomatosis (BSL, Madelung's disease) is a rare disease characterized by symmetrical and diffuse adipose tissue deposits over the neck. Its etiology is unknown. Alcoholism, liver disease, hyperuricemia, diabetes, and hyperlipidemia have been described in association with this condition. The Mediterranean region seems to have the highest incidence of BSL. We report a case of BSL in a 64-year-old man referred to our hospital because of disfigurement of the neck. The patient showed a characteristic appearance, with multiple symmetrical fat tissue deposits over the neck, back, and arms. He had a high intake of alcohol over the past 30 years, and laboratory examinations revealed elevation of transaminases. Hyperlipidemia was also observed. There was no family history of similar disorders. Surgical excision of the mass in the left side of his neck was done under general anesthesia. Histological examination of the neck mass revealed unencapsulated adipose tissue with no evidence of malignancy.