Multiple symmetric lipomatosis (MSL)

 

lymph nodes not seen in CT) // differential diagnoses. liposarcomaCushing syndrome

Growth of symmetric non-encapsulated masses of adipose tissue mostly around the face and neck, typically:

rapid (!) early development, followed by slow progressive growth of adipose deposits in and around the face, neck, occipital region,supraclavicular fossa, + shoulder areas (!)

Complete surgery necessary even if not malignant:

A: Over time,

 - neck muscles may become compressed, reduced neck mobility (already started!)

 - reducing the size of the trachea and esophagus (!!)

 - with associated respiratory obstruction (!!)

 - and obstructive sleep apnea! (started, I think)

 - Patients also often have (later!) polyneuropathy!! (90%!)

Malignant transformation into liposarcoma has been reported in very rare cases.

   https://www.orpha.net/consor/cgi-bin/OC_Exp.php?Expert=2398&lng=EN

2nd causeRare, but possible after only topical corticosteroids:

"Systemic Side-Effects of Topical Corticosteroids"  

  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4171913/

B: People with multiple symmetric lipomatosis may also develop:[4][1][5]

Peripheral neuropathy (!!)

Neurological disturbances including difficulty swallowing, hoarseness (!!)

sleep problems,

tachycardia (rapid heart rate),

fluctuation in blood pressure, and breathing issues

- Other metabolic abnormalities or diseases such as hypertensiondiabetes mellitushypothyroidism, and liver disease (!)

   https://rarediseases.info.nih.gov/diseases/6957/multiple-symmetric-lipomatosis

clobetasol proprionate +  betamethasone for several months! (non-healing wounds etc.).

kidney - HPA axisCushing Syndrome ...?!  

h.a.

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