How does epithelioid sarcoma present?

It presents as a painless, firm, slow-growing, intradermal or subcutaneous nodule, often ulcerated, usually on the volar surface of the fingers or palms. It occurs most frequently on the distal upper extremity, but it may also occur on the lower extremities and occasionally in the trunk or head and neck region. Epithelioid sarcoma has a tendency to spread locally through lymphatic channels or along fascial planes, and may give rise to multiple local nodules. The clinical differential diagnosis includes mycobacterial or deep fungal infection, squamous cell carcinoma, and other soft tissue sarcomas. The male-to-female ratio is approximately 2:1, and it affects mainly young adults.

Burgos AM, Chávez JG, Sánchez JL, Sánchez NP: Epithelioid sarcoma: a diagnostic and surgical challenge, Dermatol Surg 35:687–691, 2009.