Enlarging neck and a new bump on the right. History of alcoholism.
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There are large, bilateral and symmetric non-encapsulated fatty masses in the posterior neck. A superficial, small, well-defined, encapsulated, intermediate T1 and high STIR signal intensity lesion is noted on the right side of the neck adjacent to the superior aspect of the right-sided fatty mass.
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The findings in this case are typical of Madelung disease, with bilaterally symmetric, non-encapuslated fatty masses in the posterior neck. Other differential diagnoses to consider in the case of multiple lipomatous lesions would include Dercum disease, familial multiple lipomatosis and Bannayan-Zonana syndrome.