Eumycetoma is a chronic and frequently misdiagnosed fungal condition involving skin, soft tissue, or rarely bone. The most common species is Madurella mycetomatis, and is colloquially referred to as ‘Madura foot’ (1). Eumycetoma is a disease predominantly found in the feet of labourers, and is most prevalent in Sudan, Mexico and India. It typically presents as a slow growing mass with exudative sinuses, and may take years to clinically manifest. Treatment involves surgical excision and potentially a protracted course of antifungal therapy, with a propensity for recurrence (2). We present the case of a 41-year-old Asylum Seeker from Sri Lanka who presented with a 30-year history of a slow growing left dorsal foot mass, which had been neglected whilst the patient was detained at the Nauru Regional Processing Centre for 9 years. Radiologically, a sarcoma could not be excluded, prompting surgical excision. Histopathological analysis and PAS/Grocott staining showed septated and branching hyphae seen within areas of hypereosinophilic cytoplasm. As eumycetoma was not a differential diagnosis at the time of excision, the specimen was sent in formalin and a particular fungal pathogen was not able to be identified. Despite the rarity of eumycetoma in this geographical context, this case accentuates the need for clinicians to maintain a broad range of differential diagnoses when encountering unusual chronic foot conditions in the ethnically diverse Australian population. References: 1. Lin S, Capstick R, Ng S. Actinomycetoma of the hand: a case report. ANZ J Surg. 2020;90(3):E44-E5. 2. Reis CMS, Reis-Filho EGM. Mycetomas: an epidemiological, etiological, clinical, laboratory and therapeutic review. An Bras Dermatol. 2018;93(1):8-18.