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A 55-year-old woman with a history of basal cell carcinoma and hypothyroidism presented with a changing red patch on the right upper thigh. The patch had been present since birth without symptoms until 3 months prior to presentation when the patient noted that her pants fit tighter, despite stable weight. The lesion was not painful, pruritic, or hyperhidrotic. On examination the right thigh appeared larger than the left thigh. There was a 12× 14-cm red patch overlying a 12× 18-cm rubbery lobulated swelling on the lateral aspect of the right thigh. Ultrasonography was performed and was normal. Magnetic resonance imaging showed a vascular malformation superficial to fascia.