Sarcoidosis presenting as an isolated facial swelling--an unexpected diagnosis?

Sarcoidosis is a rare chronic granulomatous disease of unknown aetiology that primarily affects individuals between 30 and 50 years of age. It is usually characterized by the presence of non-caseating, granulomatous, epithelioid tissue at the sites affected with involvement of lymphoid tissue. Sarcoidosis confined to lymph nodes, salivary glands and other tissue in the head and neck is uncommon and usually indicative of a more generalized systemic process. Within the differential diagnosis of isolated masses associated with the head and neck, sarcoidosis is indeed rare. We report a case of systemic sarcoidosis presenting as a small localized facial swelling. The report illustrates that other symptoms, albeit mild, may direct the clinician to a provisional diagnosis of generalized sarcoidosis. CLINICAL RELEVANCE: Within the differential diagnosis of isolated facial swellings, sarcoidosis is extremely uncommon. However, clinicians should consider the diagnosis, especially in the presence of other, albeit mild, symptoms.