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Madelung disease
Last reviewed: 23.04.2024
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Madelung disease (lipomatosis) is named after the author who described the disease in 1888. It is extremely rare. The disease is characterized by proliferation of adipose tissue in various areas of the human body. The preferred location of hyperplastic adipose tissue is in the region of the head and neck. Often lipomatosis symmetrically affects the parotid and submandibular glands, which determined another name for the disease - "lion's mane".
[Causes of Madelung's disease
The etiology of the disease is unknown. Assume endocrine disorders leading to lipomatosis. Some authors noted a frequent occurrence of alcohol abuse among such patients, mostly men. Clinicians also observed four patients with Madelung's disease, three of whom abused alcohol, and one patient had a blood disease in the form of thrombocytopenia. The growth of adipose tissue proceeds according to the type of infiltrative growth resembling a malignant tumor, however a pathomorphological study of the removed material shows the presence of a benign process.
Symptoms of Madelung's Disease
The increase in salivary glands increases slowly and gradually, in the initial period is not diagnosed by doctors and is often regarded as excessive completeness of the patient. When examined, a significant increase in parotid, or submandibular, or both of these salivary glands is determined, the skin does not change to color. At palpation in these areas tumor-like formations of a soft consistence are defined, painless, without precise boundaries, relatively mobile. There are no changes in the oral cavity from the mucous membrane. Clear saliva is released from the ducts of the affected glands in sufficient quantities.
On sialograms it is determined that fatty tissue permeates the salivary gland, pushing its lobules and penetrating beyond its limits.
Treatment of Madelung's disease
Treatment of Madelung's disease is only surgical and in general - palliative (sometimes by cosmetic indications). It consists in removing visible on the eye growth of the lipoma, taking into account the sparing relation to the facial nerve in case of defeat of the parotid gland. During surgery, possible severe bleeding, which must be taken into account by the operating surgeon. Especially it concerns the removal of adipose tissue in the submandibular region, since it can extend to the vascular bundle of the neck.
The prognosis for Madelung's disease is favorable, since recurrence is rare and at a relatively late time.