Epithelioid sarcoma of the extremities

On examination,there were multiple, 1 x 2 cm ulcerating nodules on the mid-anterior aspect of the right lower leg, around which there were satellite nodules along with right inguinal lymphadenopathy [Figure 1]a.{Figure 1} Histopathogical examination of the punch biopsy specimen taken from the nodule revealed collections of epithelioid cells around areas of necrosis in the dermis [Figure 2]a. Immunohistochemistry was reactive for pancytokeratin and nonreactive for CD20, CD3, CD34, CD31, CD68, CD1a [Figure 3]a, suggestive of epithelioid sarcoma. Histopathological differential diagnoses for epithelioid sarcoma include both benign and malignant conditions such as granuloma annulare, necrobiosis lipoidica, fibrous histiocytoma, nodular fasciitis, melanoma, clear-cell sarcoma of the tendon and aponeurosis, metastatic squamous cell carcinoma, synovial sarcoma, epithelioid hemangioendothelioma and malignant extra-renal rhabdoid tumors of the soft tissue.