Madelung disease

Rationale: Madelung disease (MD), a rarely reported disease, also known as benign symmetric lipomatosis, a disorder resulting from alcoholic abuse. It's largely under-recognized and under-reported, possibly because of unawareness of the condition by physicians. Patient concerns: A 45-year-old Chinese man presented with intermittent fatigue and abdominal distension and progressive bilateral breast enlargement. He has been a heavy drinker for ten years before onset of the disease with an average daily alcohol intake of more than 120 g/day. Diagnosis: Due to the patient's symptoms, laboratory test results, radiographic findings, he was diagnosed with MD. Interventions: We treated him with abstinence from alcohol and supportive therapy. Outcomes: The patient is now in stable condition, with improvement in symptoms during follow-up. Lessons: Doctors, confronted with progressive bilateral breast enlargement in a patient with alcoholic liver disease, should be aware of the underreported MD. Recognition of this syndrome could help doctors establish diagnosis and emphasize the importance of alcohol abstinence as the mainstay of management.