Diagnostic & Therapeutic Challenges of Actinomycosis: A Benign Speck Masquerading as a Soft Tissue Malignancy Actinomycosis is a chronic infection caused by filamentous gram-positive anaerobes, typically presenting in cervicofacial regions. We report a rare case involving the lower limb of an immunocompetent male, initially suspected to have soft tissue sarcoma based on imaging. The diagnosis was confirmed histologically with characteristic sulfur granules and the Splendore-Hoeppli phenomenon. Despite antibiotic therapy, non-compliancy led to disease progression and necessitated a below-knee amputation. This case emphasises the importance of early diagnosis, patient compliance, and a multidisciplinary approach in managing rare infections mimicking malignancies.
Actinomycosis.

LYMPHOEDEMA – FILARIASIS OR SOFT TISSUE SARCOMA? A CASE REPORT This is a case report of a middle-aged man who presented with chronic unilateral lower limb swelling and a mass on the same side. Several important differential diagnoses were considered. Lymphatic filariasis was included in the differential diagnoses due to a history of travel to a district endemic with filariasis in Sabah. A final diagnosis of soft tissue sarcoma was provisionally made based on the magnetic resonance imaging findings and confirmed by histopathological examination as pleomorphic dermal sarcoma. Both conditions are unusual but important causes in primary care due to their association with poor morbidity and risk of mortality. Patient management should involve a multidisciplinary team, including primary care, public health, radiology, pathology and orthopaedics.