A 46-year-old male smoker with chronic alcoholism of approximately 20 years of evolution, with subsequent alcoholic hepatitis diagnosed eight years ago.
The patient has no other relevant background.
Our patient consults for the presence of masses in the anterior and posterior cervical region, in retroauricular zones and in the anterosuperior region of thorax, of more than ten years of evolution.
These symptoms do not produce pain, dyspnea or dysphagia.
On examination swelling was observed in the anterior cervical region, diffuse, which effaced the mandibular line, along with tumors in the retroauricular areas and in the left deltoid region, plus two columomas in the posterior region of 5 cm.
They are not painful to palpation and are hard in consistency.
1.
Cardiopulmonary auscultation, abdominal palpation and neurological examination were normal.
Analytical analysis showed the following values: transferase 131 U/l; alanine transferase 71 U/l; GGT 880 U/l; total cholesterol 228 mg/dl; thyroid hormone 105.2 mg.
The initial imaging test was a chest X-ray with no pathological changes.
Subsequently the patient underwent thyroid ultrasound with normal thyroid lobes and a large bilateral subcutaneous mass.
Cervical CT showed marked accumulation of fatty tissue located mainly at subcutaneous level in the occipital region and, more caudally, at subcutaneous and deep planes reaching the carotid space.
Fat tissue distribution was diffuse, symmetrical, and no encapsulations were identified.
The fatty tissue contained both anterior jugular veins.
Biopsy confirmed the presence of adipose tissue and ruled out tumor necrosis.
An anterior cervical lipolipectomy was performed on the patient, establishing a common mental disorder, jugular veins and main nerve structures, with significant improvement in her aesthetic appearance.
The patient was referred to a mental health service in order to support the cessation of alcohol consumption.
