Case report describes diagnostic challenges in bilateral epithelioid sarcoma of the thigh

A case report and systematic literature review describes a 47-year-old woman with bilateral thigh masses. Ultrasonography and magnetic resonance imaging failed to correctly diagnose the tumors. Subsequent histopathological examination demonstrated malignant tumors arising from skeletal muscle, and immunophenotypic findings confirmed a diagnosis of classic-type epithelioid sarcoma. The specific intervention, comparator, follow-up duration, and safety data were not reported. The authors note that epithelioid sarcoma is exceedingly rare, accounting for approximately 1% of all soft-tissue sarcomas. Diagnosis is often delayed because clinical suspicion is low and imaging findings are frequently nonspecific. Key limitations of the evidence include its nature as a single case report, the absence of reported safety or outcome data, and the lack of details on therapeutic strategies. The funding source and potential conflicts of interest were also not reported. For clinical practice, this case underscores that epithelioid sarcoma should remain in the differential for soft-tissue masses, particularly when imaging is inconclusive, and that definitive diagnosis relies on histopathological and immunophenotypic analysis.