Diffuse lipomatosis in the leg after poliomyelitis

Two elderly women with gradual enlargement of the leg following paralytic poliomyelitis are reported. From the clinical appearance, plain radiograms and angiographic studies the enlargement was thought to be caused by adipose tissue. On exploration the muscles within the calfs were found to be entirely replaced by adipose tissue. Histological examination revealed diffuse lipomatosis involving skeletal muscle, fasciae and in one case even periosteum and bone. Peripheral nerves exhibited fibrosis and myelin degeneration and vessel walls showed unusual angioma-like changes. Since it is known from the literature that peripheral nerve lesions of different kinds can be followed by adipose overgrowth we believe that there is a pathogenetic relationship between poliomyelitis and the diffuse lipomatosis in the present cases.