lipomatosis

Lipomatosis is a medical term for conditions characterized by multiple lipomas, benign tumors composed of adipose tissue. Most lipomas are solitary, but lipomatosis refers to the presence of numerous lipomas under the skin, often evolving over years. Several distinct disorders are described under this umbrella: familial multiple lipomatosis, adiposis dolorosa (Dercum’s disease) with painful lipomas, and Madelung’s disease (multiple symmetric lipomatosis).

Clinical features vary by type. In familial multiple lipomatosis, numerous soft, mobile, painless nodules develop principally on the trunk and proximal limbs. In Madelung’s disease, symmetric fatty deposits accumulate around the neck, shoulders, and upper trunk, sometimes associated with metabolic abnormalities. Dercum’s disease features painful lipomas with possible widespread pain, fatigue, and obesity.

Diagnosis is usually clinical, supported by imaging if needed to assess extent or differentiate from malignant tumors. Ultrasound or MRI can confirm fatty composition and distribution; biopsy is reserved for suspicious masses to exclude liposarcoma.

Management focuses on symptoms and cosmetic concerns. Many cases require no treatment. When indicated, treatment options include surgical excision or liposuction to remove lipomas; recurrence is common. Addressing associated conditions, such as obesity or alcohol-related liver disease in Madelung’s disease, is important. Pain management is central in Dercum’s disease. Genetic counseling may be offered for familial forms.