From Posttraumatic Lipoma to Hemangioma: 2 Foreign Bodies’ 4-decade Unnoticed Presence

Summary: Traumatic masses can present a diagnostic challenge, often encompassing both neoplastic and nonneoplastic lesions. This article reports a unique case of a 51-year-old woman with a recurrent subcutaneous mass initially diagnosed as fibrolipoma through multiple surgical excisions. Despite previous histopathologic analyses, the definitive diagnosis was established as a posttraumatic hemangioma with clear traumatic etiology. The patient had a history of a penetrating slingshot injury that went unnoticed until retrospective examination following surgical intervention revealed retained foreign bodies contributing to mass recurrence. Imaging studies indicated irregular nodular formations suggestive of vascular anomalies. This case highlights the importance of considering traumatic factors in the differential diagnosis for plastic surgeons managing soft-tissue masses, and the need for comprehensive surgical excision with intraoperative assessment to prevent misdiagnosis, particularly in recurrent benign tumors. The findings underscored the potential for persistent irritative factors and the limitations of preoperative biopsies in accurately diagnosing complex lesions.