A 46-year-old male smoker with chronic alcoholism of approximately 20 years' duration, with subsequent alcoholic hepatitis diagnosed eight years ago. The patient has no other history of interest.
Our patient consulted for the presence of masses in the anterior and posterior cervical region, in retroauricular areas and in the anterior-superior region of the thorax, which had been present for more than ten years. These lumps did not cause pain, dyspnoea or dysphagia.
Examination revealed diffuse swelling in the anterior cervical region, which blurred the mandibular line, together with tumours in retroauricular areas and in the left deltoid region, plus two lumps in the posterior region of the neck, each measuring about 5 cm in diameter, rising up to the occipital area. They are not painful on palpation and are hard in consistency.

Cardiopulmonary auscultation, abdominal palpation and neurological examination were normal.
Laboratory tests showed the following values: aspartate transferase 131 U/l; alanine transferase 71 U/l; GGT 880 U/l; total cholesterol 228 mg/dl; LDL 105.2 mg/dl; triglycerides 304 mg/dl. Thyroid hormones and cortisol were normal.
Imaging tests were initially started with a chest X-ray without pathological changes. Subsequently the patient underwent a thyroid ultrasound with the result of normal thyroid lobes and a large bilateral subcutaneous lipomatous mass. The cervical CT scan showed a marked accumulation of fatty tissue located mainly subcutaneously in the occipital region and, more caudally, subcutaneously and in deep planes reaching the carotid space. The distribution of the fatty tissue 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 tumour infiltration.
The patient underwent an anterior cervical lipectomy, preserving the sternocleidomastoid, jugular veins and main nerve structures, achieving a significant improvement in aesthetic appearance.
The patient was referred to a mental health service in order to support alcohol cessation.