Chest wall mass: what lies beneath?

Clinical introduction

A 24-year-old Filipino man attended the ED with a 1-month history of a discrete swelling over his upper anterior chest wall that was rapidly increasing in size and tenderness. He denied any other symptoms. His medical history was unremarkable.

Examination revealed a tender, 7 cm x 6 cm mass over the upper part of the sternum (figure 1). The surface was smooth, it was immobile, non-compressible and the overlying skin was normothermic but mildly erythematous. Cervical lymphadenopathy was present. His vital signs were normal.

Figure 1

Chest wall mass.

Question

What is the most likely diagnosis?

Lipoma

Chondrosarcoma

Lymphoma

Mycobacterium tuberculosis (TB)

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