multiple symmetric lipomatosis

Multiple symmetric lipomatosis (MSL) is a rare condition characterized by the growth of symmetrical, non-encapsulated masses of adipose tissue in various parts of the body.

Key Features:

• Symmetry: The growths are typically symmetrical and occur on both sides of the body.
• Non-encapsulated: The fatty deposits are not enclosed within a distinct capsule or border.
• Adipose tissue: MSL involves the accumulation of excess fat in subcutaneous tissues, primarily around the neck, shoulders, upper arms, and upper trunk.

Common Affected Areas:

• Neck
• Shoulders
• Upper arms
• Upper trunk

Demographics:

• Primarily affects men, with a sex ratio of 15:1 to 30:1.
• Can occur in all ethnic groups.
• Generally occurs in mid- to late-adulthood (30-60 years of age), but cases in childhood, adolescence, and elderly have also been reported.

Other Facts:

• The prevalence of MSL is estimated around 1:25,000 in a male Italian population and in a large German cohort.
• The disease was first described by Brodie in 1846 and later by Madelung and Launois in 1888 and 1898, respectively.

References:

[1] Multiple symmetric lipomatosis is characterized by the growth of symmetrical non-encapsulated masses of adipose tissue mostly around the face and neck with variable clinical repercussions (e.g. reduced neck mobility, compression of respiratory structures) [3]. The disease is benign by nature and mostly causes an esthetic impact but there have been descriptions of serious complications due to compression of the upper aerodigestive tract by the fatty deposits [13].

Note: The references are based on the provided context and may not be a comprehensive list of all relevant sources.

Multiple symmetric lipomatosis (MSL) is a rare disorder characterized by the growth of multiple, symmetrical fatty tumors (lipomas) in various parts of the body.

Common Affected Areas:

• Neck
• Shoulders
• Trunk
• Hips
• Upper arms and thighs

These fatty deposits are typically painless and non-encapsulated, meaning they do not form a distinct border or separate from surrounding tissues. In some cases, however, MSL can cause discomfort or pain.

Key Features:

• Symmetrical growth of lipomas on both sides of the body
• Painless nature of the fatty deposits
• Non-encapsulated and disfiguring fat proliferation in affected areas

It's essential to note that MSL is a rare condition, and its prevalence and incidence are not well-documented. However, it has been reported in various countries, including Italy, where the estimated prevalence for males is 1/25,000.

References:

• [1] Madelung’s disease is characterized by the presence of fatty tumors (lipomas) located symmetrically around the neck, shoulders, trunk, hips, upper arms and thighs.
• [2] The characteristic finding of Dercum’s disease is the formation of multiple, painful growths consisting of fatty tissue (lipomas) that are found just below the surface of the skin but also deep.
• [3] It is characterized by painless non-encapsulated and symmetric fatty deposits in the neck, torso, mammary, and abdominal areas, and in the upper and lower limbs.

Multiple symmetric lipomatosis (MSL) can be challenging to diagnose, but various diagnostic tests can help confirm the condition. Here are some of the key diagnostic tests used for MSL:

• Computed Tomography (CT): CT scans with multiplanar reconstruction are an essential diagnostic tool for MSL disease [4]. They can help visualize the extent and location of the fatty tumors.
• Magnetic Resonance Imaging (MRI): MRI is considered the best diagnostic tool in evaluating the spread of adipose tissue in MSL [11, 13]. It provides detailed images of the soft tissues and can help differentiate MSL from other conditions.
• Ultrasonography: Ultrasonography is often used as a first-line imaging modality to suspect and confirm symmetrical lipomatosis [10].
• Routine Chest Radiographs: Routine chest radiographs may show abnormal symmetrical adipose mass accumulation, but they are not the most reliable diagnostic tool for MSL [11].
• Biopsy: A biopsy may be performed to confirm the diagnosis of MSL, especially if there is a suspicion of malignancy. However, it's worth noting that MSL is a benign condition.

It's essential to note that the diagnosis of MSL is often based on clinical presentation, disease history, and imaging examinations [8]. The slow growth of fat masses and alcohol-influenced decreased self-care can lead to late recognition of the disease.

References: [4] - Computed tomography with multiplanar reconstruction is an essential diagnostic tool for MSL disease. [10] - Ultrasonography is often used as a first-line imaging modality to suspect and confirm symmetrical lipomatosis. [11] - MRI is considered the best diagnostic tool in evaluating the spread of adipose tissue in MSL. [13] - MRI provides detailed images of the soft tissues and can help differentiate MSL from other conditions. [8] - The diagnosis of MSL is often based on clinical presentation, disease history, and imaging examinations.

Unfortunately, there is no effective medical treatment for Multiple Symmetric Lipomatosis (MSL) as of now.

According to the available information, surgery remains the only therapy of choice for MSL [2]. However, there are some studies that suggest that weight loss may help in halting progression in some cases, but this is not a specific drug treatment [1].

It's worth noting that most lipomas, including those associated with MSL, do not require treatment and can be left alone if they are not causing any symptoms. However, if a lipoma is bothering you, your provider can remove it surgically, which is a safe and effective procedure [9].

Unfortunately, there is no specific mention of drug treatment for MSL in the available search results.

References: [1] Weight loss may help in halting progression in some cases. [2] Currently, surgery is the only treatment available, so the removal of the fat masses remains the only therapy of choice. [9] Most lipomas don't need treatment. If a lipoma is bothering you, your provider can remove it surgically.

Multiple symmetric lipomatosis (MSL), also known as Madelung’s disease, is a rare benign condition characterized by the growth of nonencapsulated masses of adipose tissue. When diagnosing MSL, it's essential to consider several differential diagnoses that can mimic its symptoms.

Obesity and Liposarcoma: These are the main differential diagnoses for MSL. Obesity can be distinguished from MSL by a body mass index (BMI) greater than 30 kg/m², whereas liposarcoma is a type of cancerous tumor that grows in fat tissue.

Other Conditions to Consider:

• Cushing syndrome: A rare endocrine disorder caused by excess cortisol production.
• Familial partial lipodystrophy: A genetic condition characterized by abnormal fat distribution and accumulation.
• Panniculitis: An inflammation of the subcutaneous fat layer, which can cause pain and swelling.
• Endocrine disorders: Such as hypothyroidism or hyperthyroidism, which can affect metabolism and body composition.
• Primary psychiatric disorders: Certain mental health conditions, like depression or anxiety, can manifest with physical symptoms that may resemble MSL.

Diagnostic Tools: Computed tomography (CT) scans with multiplanar reconstruction are essential diagnostic tools for MSL. They help to visualize the extent of fat tissue growth and rule out other conditions.

According to [12], the differential diagnosis of obesity may also include other conditions such as familial multiple lipomatosis, Cushing's syndrome, iatrogenic cutaneous lipomatosis, encapsulated lipomas, angiolipomatosis, myxoid liposarcoma, and lymphoma.