Xiphoid Process Variations: A Review with an Extremely Unusual Case Report

The xiphoid process is a small bony feature of the anterior thoracic wall just inferior to the sternum corpus. Although the xiphoid process is commonly represented as a straight, fully ossified bone in educational textbooks, reports of anomalous processes flood the literature. The xiphoid process can be broad, thin, monofid, bifid, trifid, curved, or deflected and contain foramina. Variations can be mistaken for epigastric masses. Herein, we report an extremely unusual bifid xiphoid process that is deflected anteriorly. This case is discussed in the context of the misdiagnosis of xiphoid process variations and its importance to the clinician.