We present a 34-year-old man with pain at the level of the anterior chest wall. A lesion of the rib or rib cartilage was initially suspected. Bone scintigraphy using 99mTcmedronate was performed including single photon emission tomography(SPET).A well-delineated rounded area devoid of radioactivity was evident at the level of the sternal body. The possibility of an osteolytic lesion or an anatomic variation was considered and radiographs and X-ray computed tomography(CT)images of the involved region were performed Radiography and CT confirmed the presence of a large bony defect at the level of the sternal body. Knowledge of the existence of such anatomic variants is important to avoid misdiagnosis as an osteolytic process. The possibility of a sternal foramen should be mentioned to the clinician because infiltration, biopsy or acupuncture of this area may lead to fatal cardiac complications.