The Swelling That Would Not Go Away

Author: Rawan Alkhatib, MBBS
Peer Editor: Matthew Negaard, MD, CAQ-SM
Final Editor: Alex Tomesch, MD, CAQ-SM

A 34-year-old male patient presents to the emergency department due to a progressively expanding mass on his left buttock (Image 1). Two months prior to this visit, the patient had been injured in a motorcycle collision. Computed Tomography (CT) performed on the day of his initial injury showed a non-specific fluid infiltration over the left iliac crest, lower back, and buttock, without a large fluid collection, considered to be hematoma. (Image 2). On his second visit, there was a firm and tender mass measuring approximately 21 x 18 cm with overlying erythema on the left buttock. The patient reported progressive enlargement of this mass over the prior months and sensitivity to light touch. Vital signs were noted to be stable. CT with contrast (Image 3) as well as Magnetic Resonance Imaging (MRI) (Image 4) were performed.

Image 1. Exam view of patient's swelling. Authors' own image.

Image 2&3: Coronal and Axial CT imaging of the LLE. Authors' own image.

Image 4. Coronal and Axial T1 weighted MRI. Authors' own image.

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