Ulzerationen der unteren Extremität-nicht immer venös bedingt

Ulcerations of the lower extremity are a common reason for consultations in phlebology outpatient clinics. In addition to common differential diagnoses, such as venous, arterial and mixed ulcers, phlebologists may also encounter less frequent clinical causes of ulcerations. Careful assessment of the patient's medical history and a critical evaluation of possible differential diagnoses are therefore essential in addition to the sonographic examination. Here, we report the case of a 77-year-old patient presented by the general practitioner for the diagnostic clarification of ulcerations on the thigh that appeared three years ago. The case report describes the differential diagnostic work-up, at the end of which the ulcerations on the thigh were diagnosed as ulcerated granulomas in the context of a known sarcoidosis. However, the comprehensive diagnostic tests additionally uncovered a choroidalmelanoma withmultiple findings suspected of being metastatic, particularly in the brain and lungs. Regrettably, the patient died unexpectedly slightly prior to completion of the diagnostic process and before a specific therapy could be initiated, due to an acute hemorrhage in a cerebral round focus suspected of being metastatic.