There is considerable anatomic variation in the shape of the xiphoid of the sternum:

• xiphoid ending is classified as single, double, or triple.
• xiphoid size varies (e.g. elongated process)
• xiphoid morphology (e.g. ventral or dorsal deviation, hook-like, reverse S-shape).

Clinical presentation

Elongated and ventrally-deviated xiphoid process might mimic an epigastric mass and cause pain