Madelung disease

Case contributed by Dean Topham


Bilateral neck swelling in the setting of alcohol abuse.

Patient Data

Age: 60 years
Gender: Male

Post contrast neck CT


There is extensive fat deposition in the deep spaces of the neck with extensive adipose tissue seen in the parapharyngeal, retropharyngeal, parotid and perivertebral spaces. Both parotids are displaced anteriorly by the non-encapsulated fatty masses.  No intraparotid lesion is seen. No cervical lymphadenopathy. Within the limits of CT, no significant epidural lipomatosis seen.

Bilateral loculated pleural effuions are noted posteriorly in the upper lobes.

Case Discussion

This patient had a strong history of alcohol abuse with Child-Pugh B cirrhosis.  Alcohol abuse is a known association of this rare entity.

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