LONG-STANDING ULCERATION OF THE SOLE REVE ALING EPITHELIOID SARCOMA

Background. Epithelioid sarcoma is an uncommon malignant soft tissue t umor observed in the distal extremities of young men. We report a case of long standing ulceration of the sole which was found to be an epit helioid sarcoma. Case report. A 78-year-old woman had an indolent ulce ration of the left sole for several months. Physical examination discl osed a well demarcated 3-cm ulcerated lesion with a red center and fla t edges. Skin sections confirmed the diagnosis of epithelioid sarcoma. Cells stained positively for anti-vimentin, anti-cytokeratin and anti -epithelial membrane antigen, but not for anti-S100 protein and anti-a ctin antibodies. Wide local excision was performed. Discussion. Epithe lioid sarcoma is an uncommon malignant tumor which apparently differen tiates from mesenchymatous cells. It is usually observed in the distal extremities in young males, predominantly the hands and forearms. The tumor presents a firm, flesh-colored indolent nodule. Ulceration usua lly develops and involves the subcutis and deeper soft tissue, particu larly fascial planes, aponeuroses and tendon sheaths. Treatment is wid e surgical excision with or without radiotherapy. The case reported he re on the sole of the foot in a 78-year-old women is unusual. Clinicia ns should be aware that the initial biopsy may not be contributive and that repeated biopsies may be necessary for positive diagnosis.