OBJECTIVES

To present a case of a 59-year-old male with bilateral symmetrical lipomatosis consistent with Madelung disease.

METHODS

Design:Case Report

Setting:Tertiary Government Training Hospital

Patient: One

RESULTS

A 59-year-old alcoholic man presented with progressive, bilaterally symmetrical masses in the supraclavicular and anterior neck regions over a 12-month period. Computed tomography revealed diffuse, non-enhancing, symmetrical subcutaneous fatty deposits without delineated solid or cystic masses. The masses were surgically excised, and histopathologic analysis confirmed lipoma. Post-operative recovery was unremarkable, with significant cosmetic improvement and no recurrence in the 2 years of regular follow-up.

CONCLUSION

This case highlights the pathognomonic clinical presentation of Madelung disease in a middle-aged Filipino man with a long history of alcohol consumption and no familial predisposition. Recognition of its characteristic features—symmetry, fat distribution, association with alcoholism, and radiologic profile—is essential to avoid misdiagnosis and unnecessary interventions. Lipectomy achieved excellent cosmetic and clinical outcomes in this patient, underlining its role as the primary treatment modality.

Human ; Male ; Middle Aged: 45-64 Yrs Old ; Alcohol Drinking ; Lipoma ; Lipectomy ; Diagnostic Errors ; Recurrence ; Therapeutics ; History ; Hospitals ; Alcoholism

Objective: To discuss the case of a 36-year-old man who presented with left unilateral facial paralysis 11 days after mastoidectomy. Methods: Design: Case Report Setting: Tertiary Government Training Hospital Patient: One Results: A 36-year-old man with recurrent left ear discharge of 30 years duration underwent left canal wall-down mastoidectomy and was discharged well after 3 days. On follow up after 8 more days, he was noted to have House Brackmann IV left facial paralysis. Following 5 days methylprednisolone, neurologic evaluation and physical therapy rehabilitation, facial paralysis improved in the ensuing weeks until House-Brackmann I was achieved at week 12. Conclusion Delayed-onset Facial Palsy (DFP) following tympanomastoid surgery may be approached conservatively, including steroids, acyclovir, and, if with a history of herpes or varicella infection, immunization can be given. Prognosis for DFP is good especially when the facial nerve is identified intraoperatively during otologic surgeries
facial nerve ; mastoidectomy