Diagnostic and surgical challenges of progressive neck and upper back painless masses in Madelung’s disease: A case report and review of literature

Table 1 Main laboratory findings and other tests of the patient

Main laboratory findings	Value	Normal range
Glucose (mmol/L)	4.61	3.9–6.1
Glycated albumin (%)	14.8	11–16
Alanine aminotransferase (U/L)	12	≤ 41
Aspartate aminotransferase (U/L)	22	≤ 40
Alkaline phosphatase (U/L)	78	45–15
γ-glutamyl transferase (U/L)	46	10–60
Creatinine (μmol/L)	90	57–111
Urea (mmol/L)	3.33	3.6–9.5
Uric acid (mmol/L)	445	208–428
Total cholesterol (mmol/L)	4.62	2.6–5.2
Triglyceride (mmol/L)	2.38	0.34–1.70
Treponema pallidum antibody (S/CO)	0.08	< 1
Anti-HCV (S/CO)	0.08	< 1
Anti-HIV (S/CO)	0.14	< 1
HBsAg (IU/mL)	0	< 0.05
Anti-HBs (mIU/mL)	0.52	< 10
HBeAg (S/CO)	0.322	< 1
Anti-HBe (S/CO)	1.69	> 1
Anti-HBc (S/CO)	0.46	< 1
Pulmonary function test results
Moderate obstructive pulmonary ventilation dysfunction
The maximum voluntary minute ventilation was slightly decreased
Heart color Doppler ultrasound examination
Aortic stiffness; Enlarged left atrium
Mitral regurgitation (mild) and tricuspid regurgitation (mild)

Table 2 Baseline characteristics of 13 patients with MD treated with different interventions

Patient	Age, yr	Sex	DD	Tumor site	Comorbidities	Treatment	Follow up
1[29]	61	Male	4 yr	Mandible, elbows and abdominal area	HD, S, H, D	Alcohol abstinence, Medications to control blood pressure and blood sugar	The patient was in stable condition at follow-up 3 mo later
2[8]	69	Male	15 yr	Neck and shoulders	HD, IFH	Surgery on the right groin and Alcohol abstinence	After 1 yr follow-up, no recurrence of the right inguinal femoral hernia was found and no fat accumulation was found in the neck or other areas
3[31]	87	Male	ND	Tongue	HD, RA	An incisional biopsy, alcohol abstinence observation	On follow-up 6 mo, the tongue findings were unchanged and no new growths were observed
4[32]	45	Male	5 mo	Neck	HD	Alcohol abstinence	After four mo, the patient claimed to experience increased cervical mobility. The size of the cervical mass was also reduced with the extended neck circumference reduced by 3.8 cm
5[33]	64	Male	20 yr	Posterior pharyngeal wall, neck, torso and upper extremities	HD, H, CRLD	Surgical removal of a mass on the posterior pharyngeal wall, alcohol abstinence	During follow-up examination in 1 wk, 2 wk, and 6 mo, further improvement of his swallowing, stertor, and voice were noted
6[34]	58	Male	ND	Supraclavicular fossa and upper back	HD, AFL	Alcohol abstinence	ND
7[35]	56	Female	ND	Neck, parotid glands, supraclavicular region and larynx	B, HC, HT, Impaired glucose tolerance	ND	ND
8[36]	59	Male	20 yr	Face and neck	HD, S	Deoxycholic Acid treatment and alcohol abstinence	Although significant growth of his lipomas was noted, he also showed markedly improved compression symptoms/pain and an increased range of motion of his neck
9[37]	45	Male	2 yr	Anterior cervical region, pre- and postauricular regions bilaterally, and back	HD, D, ACP	Two-step surgical treatment and alcohol abstinence	After 1 yr of follow-up, the final esthetic result was satisfactory
10[38]	38	Male	10 yr	Shoulders, arms and upper trunk	A	Avoid alcohol intake	No further progression of the lesions was observed during the 6-mo follow-up period
11[39]	45	Male	2 yr	Bilateral breast, upper back, deltoid areas, hips, and thighs	HD	Abstinence, liver protection, and anti-fibrosis agents	This patient was followed up every 6 mo and did not undergo surgical treatment. The condition is stable as of this writing
12[40]	65	Female	ND	Macroglossia	ND	Bilateral partial glossectomy in two times	Improved initial symptoms one year after surgery
13[41]	72	Male	ND	The breasts, abdomen, and roots of thighs	S, H	Hypotensive therapy and healthier lifestyle, and diet methods to improve the metabolic syndromePlastic surgery for liposuction of inguinal lipoma	ND

A: Alcoholism; ACP: Asymptomatic chronic pancreatitis; HD: Heavy drinking; AFL: Alcoholic fatty liver; B: Bronchiectasis; CRLD: Chronic restrictive lung disease; D: Diabetes mellitus; DD: Duration of disease; H: Hypertension; HC: Hypercalcemia; HT: High triglycerides; IFH: Incarcerated femoral hernia; ND: Not detected; R: Recurrence; RA: Rheumatoid arthritis; S: Smoking.