An 83-year-old man with a history of left lower extremity pleomorphic sarcoma diagnosed and surgically resected in 1998 with neoadjuvant radiotherapy (55–60 Gy), presented with a large and partially ulcerated cutaneous lesion in the region of prior radiation and surgical treatment (Fig. 1). Six months earlier, the lesion appeared as a small ∼1 cm erythematous maculopapule that progressively enlarged. PET-CT revealed hypermetabolic foci localized to the cutaneous and subcutaneous tissues of the left calf corresponding to the location of the lesion (Fig. 2). Biopsy showed primary cutaneous diffuse large B cell lymphoma, leg-type (PCDLBCL-LT). The patient was treated with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP), and achieved a complete tumor response.