This obese woman in her thirties complained of an abdominal mass that her primary care doctor thought was an abscess. She was referred to a general surgeon for incision and drainage. The surgeon ruled out abscess by noting a three-month history of the complaint (abscesses are more acute processes) and by aspirating blood, rather than pus, from the lesion. As this was such a large and bothersome mass (the skin was about to break down over it) that the doctor decided to remove it surgically.

The specimen was a bloc of adipose tissue with a small ellipse of skin over it. The skin showed a scar from a previous Caesarian section, interrupted by a blood-filled cyst resembling a bleb, but slightly deeper. This was just the tip of the iceberg, as section of the subcutaneous tissue revealed a complex network of white fibrous bands interrupted by blood-filled cysts and patchy areas of interstitial hemorrhage. The photo above shows a central slice through the specimen, with the small skin ellipse at top center. This slab measures 12 x 9.5 cm.