To the Editor.—
Lipoma is a common tumor composed of mature fat cells usually found in the subcutaneous tissue or, less commonly, in internal organs. A diffuse multilobular lipomatosis involving the back of the neck and the shoulders in a capelike distribution has been described among wine porters in France and brewery workers elsewhere1 and is referred to as Madelung's neck.I describe herein a patient in whom such a multilobular lipoma developed on the left shoulder, due possibly to long-term, intermittent trauma caused by a heavy purse carried over this shoulder for many years.
Report of a Case.—
A 39-year-old woman was seen because of a tumor on her left shoulder that she had noticed about three months earlier. There had been no associated symptoms. The patient stated that she had carried a heavy handbag on this shoulder for about 15 years. Examination disclosed that the tumor was