Presentation
Left mid-arm region lump for the last few years. No pain.
Patient Data

There is a well-defined solid lesion in the anterior side of the left arm. The lesion is heterogeneous hyperechoic without calcification/cystic change/vascularity. There are linear incomplete internal striations. It is hyperechoic to adjacent subcutaneous fat as well to adjacent muscle. There is compressibility. The lesion shows a claw sign in relation to the biceps brachii muscle belly. The long head biceps tendon and distal biceps tendon are normal. The median nerve and the patent brachial artery are away and medial to the lesion.
Case Discussion
An elderly male presented with a long-duration history of painless arm lump. The ultrasound features of the lesion favour a lipoma. The presence of a claw sign favours an intramuscular location.
Surgery revealed a lipoma in the biceps brachii muscle.