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Xiphoid Process Syndrome

  • Chunni He
    Affiliations
    Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China
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  • Jun Li
    Correspondence
    Correspondence: Address to Jun Li, PhD, Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, No. 717, Jinbu St, Yantai, Shandong 264100, China.
    Affiliations
    Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China
    Search for articles by this author
      A 59-year-old woman presented with a 30-year history of epigastric cutaneous protuberance. A mass was visible in the mid-portion of the epigastrium, particularly when in the supine position (Figure A). Sagittal computed tomography revealed an elongated and curved xiphoid process (Figure B). The measured length, width, and thickness of the xiphoid process were 63.2 mm (reference range, 40-50 mm), 21.1 mm (reference range, 15-20 mm), and 4.9 mm (reference range, 3-5 mm), respectively. The angle from the sternal body to xiphoid process was 138° (reference range, 160°-180°).
      Figure thumbnail gr1
      FigureA, Dermatological observation. B, Sagittal computed tomography.
      Xiphoid process syndrome is considered an uncommon variation of xiphoid process with aseptic inflammation of surrounding tissues, which can be mistaken for epigastric masses. The xiphoid process can be broad, thin, monofid, bifid, trifid, curved, or deflected and contain foramina.
      • Mashriqi F.
      • D’Antoni A.V.
      • Tubbs R.S.
      Xiphoid process variations: a review with an extremely unusual case report.
      Especially prominent ventral deviation and a hook-like ending of the xiphoid process should be considered in the differential diagnosis of the suspected epigastric masses.
      • Akin K.
      • Kosehan D.
      • Topcu A.
      • Koktener A.
      Anatomic evaluation of the xiphoid process with 64-row multidetector computed tomography.
      Treatment options include block therapy, acupuncture, and surgical therapy when necessary.

      References

        • Mashriqi F.
        • D’Antoni A.V.
        • Tubbs R.S.
        Xiphoid process variations: a review with an extremely unusual case report.
        Cureus. 2017; 9: e1613
        • Akin K.
        • Kosehan D.
        • Topcu A.
        • Koktener A.
        Anatomic evaluation of the xiphoid process with 64-row multidetector computed tomography.
        Skeletal Radiol. 2011; 40: 447-452