Hemorrhagic lesion on the chest wall after trauma

A 59-year-old woman presented with a burning, rapidly progressive mass on the midchest, occurring after a fall 4 months prior. Examination found a large well-circumscribed mass over the lower xiphisternum (Figs 1 and 2). Results of baseline investigations were normal apart from mildly elevated liver function values. A computerized tomography scan confirmed a 6.4x 4.9-cm lobulated soft tissue heterogeneous-density mass located in the subcutaneous fat with ill-defined borders and no obvious infiltration of the chest wall. A single focal abnormality was noted in the liver. Several incision/drainage procedures were complicated by difficulty achieving hemostasis. Ellipse incisional biopsy was performed (Figs 3 and 4).