Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 6, 2020; 8(21): 5474-5479
Published online Nov 6, 2020. doi: 10.12998/wjcc.v8.i21.5474
Benign symmetric lipomatosis (Madelung’s disease) with concomitant incarcerated femoral hernia: A case report
Bo Li, Zheng-Xing Rang, Jia-Cong Weng, Guo-Zuo Xiong, Xian-Peng Dai
Bo Li, Zheng-Xing Rang, Jia-Cong Weng, Guo-Zuo Xiong, Xian-Peng Dai, Department of Vascular and Hernia Surgery, The Second Affiliated Hospital of Nanhua University, Hengyang 421001, Hunan Province, China
Author contributions: Rang ZX collected the clinical data; Weng JC interpreted the imaging data of the patient; Xiong GZ obtained the pathological evidence; Li B drafted the manuscript; Dai XP reviewed the manuscript draft by Li B; All the authors read and approved the final manuscript.
Informed consent statement: The patient gave his written informed consent for the publication of this case report.
Conflict-of-interest statement: The authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xian-Peng Dai, MD, Academic Research, Department of Vascular and Hernia Surgery, The Second Affiliated Hospital of Nanhua University, No. 35 Jiefang Avenue, Zhengxiang District, Hengyang 421001, Hunan Province, China. ppdaixianpeng@sina.com
Received: June 24, 2020
Peer-review started: June 24, 2020
First decision: August 21, 2020
Revised: September 4, 2020
Accepted: September 29, 2020
Article in press: September 29, 2020
Published online: November 6, 2020
Processing time: 134 Days and 23.6 Hours
Abstract
BACKGROUND

Benign symmetric lipomatosis (BSL) was first described by Brodie in 1846 and defined as Madelung’s disease by Madelung in 1888. At present, about 400 cases have been reported worldwide. Across these cases, surgical resection remains the recommended treatment. Here we report a case of neck BSL with concomitant thick fatty deposit in the inguinal region, which concealed the signs of a right incarcerated femoral hernia.

CASE SUMMARY

A 69-year-old male patient was admitted to our hospital with “abdominal pain, abdominal distension, nausea-vomiting and difficult defecation for half a month”. Moreover, he had a mass in the right inguinal region for more than 10 years. An egg-sized neck mass also developed 15 years ago and had developed into a full neck enlargement 1 year later. In addition, the patient had a history of heavy alcohol consumption for more than 40 years. With the aid of computerized tomography scan, the patient was diagnosed with BSL and a low intestinal mechanical obstruction caused by a right inguinal incarcerated hernia. Under general anesthesia, right inguinal incarcerated femoral hernia loosening and tension-free hernia repair was performed. However, this patient did not receive BSL resection. After a 1-year follow-up, no recurrence of the right inguinal femoral hernia was found. Moreover, no increase in fat accumulation was found in the neck or other areas.

CONCLUSION

Secretive intraperitoneal fat increase may be difficult to detect, but a conservative treatment strategy can be adopted as long as it does not significantly affect the quality-of-life.

Keywords: Benign symmetric lipomatosis; Madelung’s disease; Neck; Inguinal region; Inguinal incarcerated hernia; Case report

Core Tip: Secretive increase of intraperitoneal fat may be difficult to detect until the appearance of abdominal symptoms is observed. A conservative treatment strategy can be selectively adopted as long as the patient’s self-perceived quality-of-life is not affected.