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Madelung's disease
Last reviewed: 05.07.2025
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Madelung's disease (lipomatosis) is named after the author who described the disease in 1888. It is extremely rare. The disease is characterized by the growth of adipose tissue in various areas of the human body. The favorite localization of hyperplastic adipose tissue is the head and neck area. Lipomatosis often 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. Endocrine disorders leading to lipomatosis are suggested. Some authors noted frequent alcohol abuse among such patients, mainly men. Clinicians also observed four patients with Madelung's disease, three of whom abused alcohol, and one patient was diagnosed with a blood disorder in the form of thrombocytopenia. The proliferation of adipose tissue occurs as an infiltrative growth resembling a malignant tumor, however, pathomorphological examination of the removed material shows the presence of a benign process.
Symptoms of Madelung's disease
The enlargement of the salivary glands increases slowly and gradually, in the initial period it is not diagnosed by doctors and is often regarded as excessive obesity of the patient. During examination, a significant enlargement of the parotid, or submandibular, or both salivary glands is determined, the skin does not change color. During palpation in these areas, tumor-like formations of soft consistency are determined, painless, without clear boundaries, relatively mobile. In the oral cavity, no changes in the mucous membrane are noted. Transparent saliva is secreted from the ducts of the affected glands in sufficient quantities.
Sialograms show that fatty tissue penetrates the salivary gland, pushing apart its lobules and penetrating beyond its limits.
Treatment of Madelung's disease
Treatment of Madelung's disease is only surgical and generally palliative (sometimes for cosmetic reasons). It consists of removing the visible lipoma growth, taking into account the sparing attitude to the facial nerve in case of damage to the parotid gland. During surgery, severe bleeding is possible, which must be taken into account by the operating surgeon. This is especially true for the removal of fatty tissue in the submandibular region, as it can spread to the vascular bundle of the neck.
The prognosis for Madelung's disease is favorable, since recurrence is rare and occurs at a fairly late stage.