A board-certified physician, Rafael Schulze, MD, practices at Advanced Dermatology and Cosmetic Surgery in Orlando, Florida. A knowledgeable skin cancer surgeon, Dr. Rafael Schulze co-authored “Chronic Palmar Ulcer: A Case of Epithelioid Sarcoma” in the International Journal of Dermatology (December, 2002).

1. DIAGNOSING AND
TREATING EPITHELIOID
SARCOMA
Rafael Schulze

2. Introduction
• A board-certified physician, Rafael Schulze, MD, practices at Advanced
Dermatology and Cosmetic Surgery in Orlando, Florida. A knowledgeable skin
cancer surgeon, Dr. Rafael Schulze co-authored “Chronic Palmar Ulcer: A Case
of Epithelioid Sarcoma” in the International Journal of Dermatology
(December, 2002).
A rarely occurring malignant soft tissue tumor, epitheloid sarcoma (ES)
typically presents in the hands and forearms of young men.The tumor appears
as a flesh-colored, firm indolent nodule, or slightly elevated skin lesion. Known
for involving the regional lymph node and local recurrence, the tumor may be
mistaken for chronic inflammatory processes, as well as fibrohistiocytic tumors
and necrotizing granulomas.
Misdiagnosis is a major issue, as it can result in improper or delayed treatment,
which impacts chances of patient survival.The nonpainful, indolent growth
patterns means that ES is often present for an extended period before medical
attention is sought.The recommended treatment for ES involves wide surgical
excision, often in tandem with radiotherapy.