Epithelioid Sarcoma Presenting as a Benign Foot Ulcer

Background: Epithelioid sarcomas are rare mesenchymal tumours that infrequently present to dermatologists. The often banal spindle and polygonal cell histology can mimic granulomas. Objective: Our aim is to raise the clinician's awareness of a potentially devastating malignancy that can remain unsuspected. Method: We present a case of an epithelioid sarcoma that was misdiagnosed as a benign foot ulcer and treated as such for nearly half a year. An uncertain histology further delayed definitive treatment. At the time of surgery, the tumour had infiltrated deeply. Conclusion: The often nondescript clinical and histologic nature of epithelioid sarcomas demands a high level of vigilance on the part of the clinician.