Introduction Madelung's disease, also known as Multiple Symmetric Lipomatosis (MSL) or the Launois-Bensaude syndrome, is characterized by subcutaneous lipid deposits, which, unlike lipomas, are nonencapsulated. The disease is diagnosed mainly in Mediterranean countries, and 90% of all cases involve male alcoholics. These masses are usually found on the neck, chest, abdomen, and arms. The symptoms are the result of acute sensorimotor axonal neuropathy caused by compression. Treatment (surgical and/or medical) does not produce significant or lasting results. Case report We describe the case of a 57-year old male alcoholic (daily ethanol intake: approximately 2 L of wine), who has been treated and followed by our staff for 6 years. Discussion and conclusions As this case illustrates, management of MSL is often associated with serious difficulties related to the patient's alcoholism. The effects of adipose tissue masses on the sensitive and motor nervous system are complicated by the effects of alcoholic neuropathy, requiring complex long-term monitoring. Treatment is often compromised by poor compliance related to patient's drinking problems. Madelung's disease is currently regarded as a rare disease, although we suspect that the incidence in Italy (and in the rest of the world) has probably been underestimated for various reasons.
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