Images in the Medical Sciences

Madelung Disease

Case Presentation

A 71-year-old man presented with progressive painless swelling of the neck for 20 years. The medical history was unremarkable. He had a history of chronic alcohol consumption for 30 years and was a heavy smoker with a 30-pack-year history. The patient did not have signs of sensory, motor or autonomic neuropathy. The physical examination was unremarkable, with the exception of bilateral swelling over the submandibular, cervical and nuchal areas without definite margins (Figure A). The swelling