Judi, how about this physician? Maybe he recommend someone?

[Guest guest]

F. Sheehy, M.D.

1401 Avocado #903

Newport Beach, California, 92660, USA

(949) 640 8620

Familial Multiple Lipomas

This is a condition in which groups of fat cells in the subcutaneous

tissues begin to grow spontaneously and produce multiple fatty lumps

underneath the skin. These are benign fatty tumors or lipomas. This

condition is quite common and is frequently genetic in origin, due to a

mutation of the mitochondrial DNA.

The presentation of this disease is variable. Most patients have

multiple small fatty subcutaneous nodules that are painless. The number

of nodules may vary from very few to many. They are mostly located on

the arms, forearms, legs and trunk but they can occur in the neck, face

and buttocks. In some patients, if neglected, these fatty lumps can grow

to a large size and can make the patient appear grotesque.

While these lumps are usually painless, in some patients they are

painful and if large, they are subcategorized into an entity called

Dercum's Disease. This disease was first described by Dr. F. X. Dercum

in 1888, when he found a patient with large painful subcutaneous tumors.

The correct medical term is called Adiposis Dolorosa. In this aspect of

familial multiple lipomatosis, the fatty lumps are painful. The degree

of pain varies from being mild to severe. The cause of the pain is

unknown.

It has been reported to respond to intravenous lidocaine and oral

mexiletine. Both these drugs are used to treat irregular heartbeats and

how they reduce the pain is unknown. More recently, it was discovered

that interferon alfpha-2b at low doses can relieve pain for a long time.

The size of the lipomas was not affected. Sinequan, an antidepressant,

has been reported to help. Some patients with Adiposis Dolorosa are

obese and have depression so they might benefit from treating the

depression. Since it is a disease that is seldom fatal, very little

research is being done.

Another variation of this disease is called Madelung's Disease. This

group of patients, as well as having multiple subcutaneous lumps, will

also get these fatty lumps in places that disrupt function of some

organs, like the larynx, the esophagus, the intestine, the lungs or the

heart. The lumps are usually not painful.

When any of these lumps get so large that they become unsightly, then

they can be removed surgically or they can be treated with liposuction.

Most of these lumps will grow back and may have to be removed

repeatedly.

These fatty lumps seldom become malignant. When they do change into

malignant lipomas, they grow more rapidly and when continuous growth

occurs in any one lump, that lipoma should be removed and examined

pathologically.

Dercum's disease and Madelung's disease are now becoming more

recognized and more research will be done in the future.

Some physicians believe that patients with these diseases have an

increased incidence of cancer. There have been no large studies done to

prove this but patients with cancer seem to have an increased incidence

of these subcutaneous nodules.

If you need more information about this rather common condition,

please call my office for an appointment and I will be happy to discuss,

clarify and manage your condition.

http://www.medonc.com/lipomas.htm

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org