New England Journal of Medicine, Vol.369(4) : e5, 2013
A 76-year-old woman presented with a several-year history of slow-growing masses on both lateral aspects of her tongue. She reported having no pain, dysphagia, or dysarthria. She also reported no intake of alcohol, and she was not obese (body-mass index [the weight in kilograms divided by the square of the height in meters], 23.4). The physical examination showed diffusely yellow globular masses on both lateral borders of the tongue (Panels A and B). There were no abnormal findings on the neck and superior portion of the trunk. Excisional biopsy was performed, and histologic analysis revealed mature fat tissue consistent with lipoma. Symmetric lipomatosis of the tongue (related to Madelung's disease) occurs in the Mediterranean region in adults between the ages of 30 and 60 years of age and is strongly associated with alcohol abuse. Solitary symmetric lipomatosis that develops on the tongue in Asian populations tends to occur predominantly in patients who are older than 60 years of age and who have no history of alcohol abuse or adiposity elsewhere in the body.