Ardeleanu V, Chicos S, Georgescu C, Tutunaru D
Emergency Clinical Hospital, First Surgery Clinic, Galati, Romania.
Chirurgia (Bucur). 2013 Jul-Aug;108(4):580-3.
Benign symmetrical lipomatosis (BSL), or Madelung's disease, is a rare disease characterized by the progressive growth of diffuse, painless, non-enveloped symmetric lipomas. The etiology of this disease remains unknown, although it was associated in the medical literature with alcohol and nicotine abuse, metabolic disorders and a number of malignancies. It is assumed that there is a genetic predisposition for this affliction. The management in such cases is surgical removal of the lipomas, most times in several sessions, but this is often followed by relapse. However, surgical removal of the lipomas can provide satisfactory patient functionality and cosmetic results. The differential diagnosis is made with morbid obesity, Cushing syndrome, angiolipomatosis, encapsulated lipomas, neurofibromatosis, myxoid liposarcoma, lymphoma, salivary gland disease, Frolich and lipomatosis syndrome in patients infected with HIV. The current paper reports the case of a 55 year-old man, who presented with several large lipomatous masses, arranged symmetrically on the front and back of the trunk, and several smaller lipomas in the upper and lower limbs. Treatment consisted of resection of these lipomas in several sessions, without recurrence at one year after the last operation.
良性对称性脂肪瘤病（BSL），即马德隆氏病，是一种罕见疾病，其特征为弥漫性、无痛性、无包膜的对称脂肪瘤进行性生长。尽管在医学文献中该疾病与酒精和尼古丁滥用、代谢紊乱以及多种恶性肿瘤有关，但其病因仍不明。据推测，这种疾病存在遗传易感性。此类病例的治疗方法是手术切除脂肪瘤，多数情况下需分多次进行，但术后常复发。然而，手术切除脂肪瘤可使患者功能和外观得到满意效果。鉴别诊断需考虑病态肥胖、库欣综合征、血管脂肪瘤病、包膜性脂肪瘤、神经纤维瘤病、黏液样脂肪肉瘤、淋巴瘤、涎腺疾病、弗罗利希综合征以及HIV感染患者的脂肪瘤病综合征。本文报告了一例55岁男性病例，该患者躯干前后有多个对称分布的大脂肪瘤块，上下肢有多个较小脂肪瘤。治疗方法是分多次切除这些脂肪瘤，最后一次手术后一年未复发。
