Long term assessment of intralipotherapy in Madelung’s disease

ABSTRACT

Madelung’s disease is characterised by multiple symmetric abnormal fat masses in the head, neck and upper limbs. Surgical excision or liposuction is the only realistic available option, although palliative in nature. The serial intralipotherapy with phosphatidylcholine/deoxycholate has been proposed as a non-invasive treatment of Madelung’s disease. The authors used serial intralipotherapy with phosphatidylcholine/deoxycholate in two patients affected by Madelung’s disease. Three injections per lesion per patient were performed with 1 month’s interval. Pre- and 6 months’ post-treatment dimensions were assessed with ultrasound scan and patients were observed along a 5 years’ clinical follow-up. A 42.5% average size reduction was reported in all treated lesions. About 33% recurrence rate was observed in the 5 years’ follow-up. We confirm the efficacy of intralipotherapy in the non-invasive palliative treatment of Madelung’s disease, as a valid option to reduce the volume and limit the growth of the pathological adipose masses.

 

MissingLinkText

KEY WORDS

Deoxycholate - intralipotherapy - Madelung’s disease - phosphatidylcholine - ultrasounds

 

 

MissingLinkText

Conflict of Interest

None declared.

• REFERENCES

• 1 Madelung OW. Uber den fetthals (diffuses lipom des halses). Langenbecks Arch Klin Chir 1888; 37: 106-30
• 2 Knöbber D, Feidt H, Hornberger W. Madelung’s lipomatosis of the neck - expression of an alcohol-induced endocrine disorder?. HNO 1986; 34: 474-6
• 3 Carlin MC, Ratz JL. Multiple symmetric lipomatosis: Treatment with liposuction. J Am Acad Dermatol 1988; 18: 359-62
• 4 Rotunda AM, Kolodney MS. Mesotherapy and phosphatidylcholine injections: Historical clarification and review. Dermatol Surg 2006; 32: 465-80
• 5 Hasegawa T, Matsukura T, Ikeda S. Mesotherapy for benign symmetric lipomatosis. Aesthetic Plast Surg 2010; 34: 153-6
• 6 Enzi G. Multiple symmetric lipomatosis: An updated clinical report. Medicine (Baltimore) 1984; 63: 56-64
• 7 van Aerts LA. Adipocytolysis by subcutaneous injection of Lipostabil. RIVM Brief Report. 360007001/2010 2010
• 8 Food and Drug Administration (FDA). FDA news release. Consumer inquiries: 888-INFO-FDA. Media inquiries: Tom Gasparoli, 301-796-4737. Available from: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm207453.htm [Last accessed on 2010 Apr 07]
• 9 Law April the 8 th 1998 number 94. Official Gazzette of the Italian Republic, number 86, April the 14 th 1998, Polygraph Institute and National Mint, Italy
• 10 Bechara FG, Sand M, Sand D, Rotterdam S, Stücker M, Altmeyer P. et al. Lipolysis of lipomas in patients with familial multiple lipomatosis: An ultrasonography-controlled trial. J Cutan Med Surg 2006; 10: 155-9
• 11 Rey JW, Schreiner O, Barreiros AP, Heise M, Krupp M, Schuchmann M. et al. Acute renal failure and liver dysfunction after subcutaneous injection of 3-sn-phosphatidylcholine (Lipostabil® )-case report. Z Gastroenterol 2011; 49: 340-3
• 12 Zeisel SH. Dietary choline deficiency causes DNA strand breaks and alters epigenetic marks on DNA and histones. Mutat Res 2012; 733: 34-8
• 13 Newberne PM, Conner MW. Dietary modifiers of cancer. Prog Clin Biol Res 1988; 259: 105-29
• 14 Sakakima Y, Hayakawa A, Nagasaka T, Nakao A. Prevention of hepatocarcinogenesis with phosphatidylcholine and menaquinone-4: In vitro and in vivo experiments. J Hepatol 2007; 47: 83-92
• 15 Sakakima Y, Hayakawa A, Nakao A. Phosphatidylcholine induces growth inhibition of hepatic cancer by apoptosis via death ligands. Hepatogastroenterology 2009; 56: 481-4
• 16 Dial EJ, Doyen JR, Lichtenberger LM. Phosphatidylcholine-associated nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit DNA synthesis and the growth of colon cancer cells in vitro . Cancer Chemother Pharmacol 2006; 57: 295-300
• 17 Schuller-Petrovic S, Wölkart G, Höfler G, Neuhold N, Freisinger F, Brunner F. Tissue-toxic effects of phosphatidylcholine/deoxycholate after subcutaneous injection for fat dissolution in rats and a human volunteer. Dermatol Surg 2008; 34: 529-42
• 18 Lipostabil N® i.v. 5 ml information sheet Artesan Pharma. Luchow, Germany
• 19 Salti G, Ghersetich I, Tantussi F, Bovani B, Lotti T. Phosphatidylcholine and sodium deoxycholate in the treatment of localized fat: A double-blind, randomized study. Dermatol Surg 2008; 34: 60-6