頸部病変に対して脂肪切除を行った多発性対称性脂肪腫症例

抄録

Multiple symmetrical lipomatosis is a slowly progressive disease characterized by multiple accumulations of nonencapsulated lipomas with a symmetrical distribution in the neck, shoulders, trunk, and limbs. It is most common in middle-aged men with a history of heavy alcohol intake. Cases have been accumulating in recent years, mainly in southern Europe, whereas reports from Japan are still limited. The pathogenesis of the disease has not yet been completely elucidated. While no standard treatment has been established, lipectomy has been reported to be effective for neck lesions. In this article, we report our experience of surgical resection of a neck lesion in a case of multiple symmetrical lipomatosis, with a brief review of the literature. The patient was a 60-year-old man who presented to our outpatient clinic with the chief complaint of neck swelling. We decided to perform surgery for cosmetic purposes. Lipectomy of the neck was performed by dissecting the fat tissue in both the shallow and deep layers of the platysma. Postoperatively, a hematoma formed, and hemostasis was performed under general anesthesia. The patient was discharged on postoperative day 10, and good cosmetic results were achieved with no obvious recurrence on MRI at six months after the surgery. Patients with multiple symmetrical lipomatosis often have hepatic damage due to a history of heavy alcohol consumption; thus, postoperative bleeding is frequent and careful attention must be paid. Although the pathogenesis of the disease is still unknown and no standard management methods have been established, it should be noted that there is a long-term risk of postoperative recurrence and sudden death due to autonomic disorder.