Madelung's disease is an extremely rare disorder of unknown etiology. It is characterized by the huge, bilateral, fatty deposits in regions of the neck, shoulders and the upper extremities. A 69-old patient with developed symptoms of Madelung's disease with a 12-years history is described in this study. The patient was initially considered to have a goiter and chronic heart insufficiency, for which he has been treated for three years. Although the Madelung's disease can be diagnosed right after detailed clinical examination, this study pointed out possible diagnostic and therapeutic mistakes when a physician in a differentiation of symmetrical neck and shoulder swellings doesn't consider the possibility of diagnosing a Madelung's disease.