Epithelioid Sarcoma Presenting as Recurrent Thumb Ulcer: a Lesson to Learn.

Epithelioid sarcoma first described by Enzinger (Cancer 26:1029-41, 1970) is a rare soft-tissue sarcoma typically presenting as a subcutaneous or deep dermal mass in distal portions of the extremities of adolescents and young adults. They are frequently mistaken for ulcers, abscesses, or infected warts that fail medical management. Patients often develop multiple local recurrences of long duration, with subsequent metastases in 30 to 50% of cases (Chase and Enzinger (Am J Surg Pathol 9:241-63, 1985)). We here report a case of left thumb epithelioid sarcoma that presented as an ulcer and subsequently metastasized to forearm, arm, axillary lymph nodes, and lungs.