Key result
Wide local excision and adjuvant radiotherapy successfully treated an unusual presentation of epithelioid sarcoma in a 21-year-old male, with no disease recurrence or metastasis observed over 4 years.
Why the study?
Unusual presentations of epithelioid sarcoma, such as a chronic traumatic ulcer, can delay diagnosis and treatment and worsen prognosis.
Case Report (n=1)
No
Epithelioid sarcoma can present atypically as a chronic non-healing traumatic ulcer, and early diagnosis followed by wide excision and radiotherapy can yield favorable long-term outcomes without recurrence.
Supports multimodal therapy for rare epithelioid sarcoma; hypothesis-generating and should not change practice.
Epithelioid sarcoma is a rare soft tissue sarcoma. It is a slow-growing neoplasm, which usually presents as a painless mass in the extremities and typically grows along deep dermal and subcutaneous planes. In contrast to other types of sarcoma, it has a strong tendency for nodal metastasis and local metastasis adjacent to the primary lesion within the affected limb. In this article, we present a case of chronic traumatic ulcer in the upper extremity in an adolescent male that was subsequently diagnosed as epithelioid sarcoma, which is a very unusual mode of presentation of this particular tumour. The patient was treated with wide local excision and reconstruction with a free flap. Histopathological examination and immunochemistry studies confirmed the diagnosis and the patient underwent radiotherapy post-operatively as a part of the treatment regime. His post-treatment period was unremarkable, and he was put on regular surveillance to monitor the development of any signs of disease recurrence. Patients with epithelioid sarcomas often present late due to the slow-growing nature of the tumour. Unusual presentations like this will further delay the diagnosis and treatment, which will eventually worsen the prognosis. Awareness of such presentations can encourage primary care physicians to make early referrals to experts, which, in turn, may help the patients get early treatment and have a better prognosis.
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Mohammedali et al. (2021) conducted a case report in Epithelioid sarcoma (n=1). Wide local excision and adjuvant radiotherapy was evaluated on Disease recurrence or distant metastasis. Wide local excision and adjuvant radiotherapy successfully treated an unusual presentation of epithelioid sarcoma in a 21-year-old male, with no disease recurrence or metastasis observed over 4 years.
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