Dercum's disease: A unique case of recrudescent lipomas necessitating surgery

Abstract

Dercum’s disease, alternatively known as adiposis dolorosa, is a rare condition characterized by multiple lipomas causing palpable skin defects associated with pain and tenderness. The prevalence and etiology of this disease remain unknown despite its debilitating impact on affected individuals. Current literature describes individuals with Dercum’s disease to be predominantly older, obese females. This report details a unique case involving a 29-year-old male who, between 2022 and 2024, underwent surgical excision of over 80 lipomas on five separate occasions. Prior to surgery, the nodules were assessed in an outpatient setting to determine their location, confirm skin changes, and evaluate their debilitating effects on the patient’s quality of life, thereby justifying the surgical approach. Histology proved all the lesions to be benign lipomas. Subsequent to the initial lipoma excisions, new lesions recurred on the torso and extremities. Differential diagnoses were considered such as neurofibromatosis, multiple familial lipomatosis, Madelung disease, Bannayan-Zonana syndrome, and Cowden syndrome were ruled out by family history, location of lesions, and histology. Although Dercum’s disease has been recognized since the late 1800s, advances in understanding and treating the condition have been limited. This case aims to shed light on the experience of a young patient with multiple recrudescent lipomas necessitating surgery.