熱帯医学と外科

概要

Multiple Symmetrical Lipomatosis in a 67-Year Old African Male: First Case Report within a Resource-Limited Setting

Veronique Suttels, Tertius Venter and Michelle White

Introduction: Multiple Symmetrical Lipomatosis (MSL) is a progressive disease presenting with symmetrically distributed (large) lipomata over the occiput, head, neck, shoulders and trunk resulting in gross deformity. Over 90% of cases are associated with chronic alcohol abuse, and associations with metabolic disorders are also common but malignancy is rare. To date there is only one report of MSL in an African-American patient and no reported cases in Africa.

Case Presentation: We report the case of a 67-year old African male with a history of gout and chronic heavy drinking presenting with typical features of multiple symmetrical lipomatosis. The lipomata were successfully removed by a visiting surgical mission team.

Discussion: Exact pathogenesis and incidence of MSL remain unclear. Misdiagnosis is common and diagnosis in resource-limited settings should be prompted by the history of alcohol abuse and characteristic presenting features of multiple symmetrical lipomatosis. Challenges of surgical interventions in low-resource settings are discussed.

Conclusion: Clinicians should be aware of the condition and its association with metabolic disorders and rarely malignancy. In resource-limited settings, ethical and cultural factors should be considered before proceeding to surgery.