Unilateral limb edema is a common diagnostic problem. Apart from the most common pathologies, i.e. chronic venous insufficiency and lymphedema, differential diagnosis should include unusual causes of asymmetric extremity edema. We presented a case of 41-year-old man with suspicion of lymphedema of the left calf, who reported to a lymphology clinic. We discuss subsequent steps of the diagnostic procedure in case of the calf edema. In our patient, neurogenic muscle hypertrophy was found to be the cause of the calf enlargement. The diagnosis was confirmed by results of ultrasound, magnetic resonance, computed tomography, lymphoscintigraphy and electromyography examinations. Neurogenic muscle hypertrophy is a very rare and unusual cause of the calf enlargement. Nevertheless, it should be taken into account in the differential diagnosis.
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