A 76-year-old man was referred for evaluation of a right lower leg mass. He reported an acute exacerbation of chronic pain in the affected limb. He had no recent injury or antecedent trauma but recalled a remote history of a right tibia fracture 60 years previously that was treated nonoperatively, with subsequent mild chronic leg pain attributable to the fracture. He stated that he had always perceived a 'knot' over the area since the injury, but that the knot had progressively enlarged during the last 3 months. His symptoms were activity-related but he also complained of weakness in the leg that had been present since the initial injury. He denied fevers, chills, night pain, or weight loss.