Head and Neck Imaging

Benign symmetrical lipomatosis

rare proliferative disorder of the adipose tissue, with onset in adulthood. The disease is characterized by symmetrical fat deposits, predominantly in the neck and shoulder area, upper back and arms. A classification in three types, according to the distribution of the pathological fatty tissue was proposed:

  • localized cervical fat proliferation or Madelung Fetthals (type I);

  • localization in the shoulder area or pseudoathletic type (type II);

  • localization in the pelvic region or gynaecoid type (type III).

    The tissue swelling develops rapidly during the first few years of the disease, remaining relatively constant afterwards. Some slow progression or regression is sometimes reported, but spontaneous remission does not occur. Patients usually seek medical advice because of the sometimes grotesque disfigurement. Compression of the pharynx, larynx, vessels and nerve trunks, leading to dyspnoea and superior vena cava syndrome, has been described. There is a strong association between this disease and moderate to heavy alcohol consumption; association with exposure to petroleum and coal products has also been reported.

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