Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, 335 Pangyo-ro, Bundang-gu, Gyeonggi-do, Republic of Korea.
BMC Womens Health. 2020 Sep 14;20(1):200. doi: 10.1186/s12905-020-01055-w.
Multiple Symmetric Lipomatosis (MSL) is a rare disorder related to fat metabolism and lipid storage. The condition results in characteristic depositions of fat, especially around the cephalic, cervical, and upper thoracic subcutaneous. It is much more common in adult males who live in the Mediterranean region and has only rarely been reported in Asian females. In this report, we present a case of an Asian female with MSL and also review the clinical features of the condition, including radiological and histological findings required for proper diagnosis and management.
A 59-year-old Korean female came in with a chief complaint of palpable mass present in shoulder and upper back regions. Images showed diffuse non-encapsulated adipose tissue in the subcutaneous layer of the suboccipital, posterior neck area. The patient wanted to remove the mass for cosmetic reasons and discomfort. Excisional biopsy was planned. Preoperative blood analyses showed deteriorated liver function, and the computed tomography findings were consistent with liver cirrhosis. Detailed history taking revealed that she consumed highly levels of alcohol. Lipectomy was performed and the histological findings demonstrated large dystrophic adipocyte morphology. The patient was recovered uneventfully.
When patients have multiple symmetric lipomatous lesions, clinicians should suspect MSL and survey possible associated conditions, such as alcoholism, liver cirrhosis, dyspnea, and neuropathy in detail.
多发性对称性脂肪瘤病(MSL)是一种与脂肪代谢和脂质储存有关的罕见疾病。这种疾病会导致脂肪的特征性沉积,特别是在头部、颈部和上胸部的皮下。它在居住在地中海地区的成年男性中更为常见,在亚洲女性中很少有报道。在本报告中,我们介绍了一例亚洲女性 MSL 病例,并回顾了该疾病的临床特征,包括影像学和组织学表现,这些表现对于正确诊断和管理是必需的。
一名 59 岁的韩国女性因肩部和上背部有可触及的肿块而来就诊。影像学显示枕后、颈后区域皮下层有弥漫性无包膜的脂肪组织。患者出于美容和不适的原因希望切除肿块。计划进行切除活检。术前血液分析显示肝功能恶化,计算机断层扫描结果与肝硬化一致。详细的病史询问显示她大量饮酒。进行了脂肪切除术,组织学检查显示大的营养不良脂肪细胞形态。患者术后恢复顺利。
当患者出现多发性对称性脂肪瘤样病变时,临床医生应怀疑 MSL,并详细调查可能的相关疾病,如酒精中毒、肝硬化、呼吸困难和神经病。