Multiple Symmetric Lipomatosis, also known as Madelung’s Disease, is an uncommon disorder characterized by fat deposits or the symmetrical development of lipomas throughout the neck, shoulders, and upper body. Some people may notice a rapid rise in fatty deposits within a few months, while others may experience a gradual increase over time.

Moreover, Multiple Symmetric Lipomatosis often affects men with a history of alcohol consumption, people of Mediterranean heritage, and those aged 30-60. Non-alcoholics and women equally may get the condition. The actual cause of Madelung is unclear. However, there may be a significant link between drinking and people who get the condition later in life. Approximately 90% of those affected have a history of alcoholism.


Multiple Symmetric Lipomatosis is distinguished by the development of fatty tumors (lipomas) that are symmetrically located around the following:

  • Shoulders
  • Hips
  • Thighs
  • Neck
  • Trunk
  • Upper arms

Many symmetric fat tumors produce lipomatosis. As the fatty mass stabilizes, it slows. Fat compresses the airway, esophagus, voice box, and carotid blood vessels, causing symptoms.

Depending on the extent of the condition, fatty tumors may cause patients to suffer the following symptoms:

  • speaking (dysphonia)
  • swallowing (dysphagia)
  • difficulty breathing (dyspnea)

Madelung’s illness is characterized by reduced neck motion and sleep apnea. It may also result in mental disorders and social isolation. Multiple Symmetric Lipomatosis is often related to metabolic problems and other illnesses such as diabetes, hypertension, gout, liver disease, and hypothyroidism.


A comprehensive physical examination and history of illness review are used to identify Multiple Symmetric Lipomatosis. Imaging studies like magnetic resonance imaging (MRI) and computed tomography (CT scan) are also beneficial. An MRI scan is the primary approach for detecting lipomas, followed by a biopsy to confirm the diagnosis.


Surgical excision of fatty deposits from affected regions is often used as a treatment. Among the treatment possibilities are:

  • surgical resection of fatty tumor(s)
  • Liposuction
  • injection lipolysis. 

Although ultrasound-assisted liposuction has been used successfully to remove single fatty tumors, the fat deposits do not degenerate spontaneously and can recur even after surgery.

After a lipolysis injection, adhesions and fibrosis may occur, interfering with other surgical or liposuction therapy. Drug therapy has not been beneficial in treating Multiple Symmetric Lipomatosis, and salbutamol is being investigated as a possible therapeutic drug, although findings have been variable.

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