感染を契機に発見された良性対称性脂肪腫症の1例

Benign symmetric lipomatosis accompanied with infection：A case report

I．はじめに

　良性対称性脂肪腫症（benign symmetrical lipomatosis：以下，BSL）は1888年，Madelung^1）によって総括して報告された巨大な脂肪腫が頸部，背部，体幹などにびまん性，対称性に生じ独特な外観を示す疾患である。今回われわれは，左頸部腫脹を呈し，感染を契機に発見されたBSLの1例を経験したので文献的考察を加え報告する。

　A 26-year-old man consulted our hospital with a chief complaint of throat pain and left cervical swelling. The swelling was symmetrical,a so-called“horse-collar deformity”,and his left neck was diffusely indurated. However,only slight erythema in the oropharynx was observed. Enhanced CT revealed edematous swelling of subcutaneous adipose tissues with more swelling in the left neck than the right. There was also a swelling of the left sternocleidomastoid muscle and lymph nodes inside the muscle. Therefore,benign symmetric lipomatosis with a cervical phlegmon was diagnosed. This entity has not been reported in the past,but the phlegmon was initially controlled by intravenous antibiotics and steroids. However,if the infection progressed to an abscess,it could not be drained because of the large amount of cervical fat. He refused surgical excision of the fatty mass. In the future,an operation will be reconsidered when infection recurres.