Prolonged Fever and Severe Hypercalcemia Revealing Systemic Extrapulmonary Sarcoidosis: A Lesson to be Learned

Abstract

Sarcoidosis often manifests with pulmonary involvement, making isolated extrapulmonary presentations rare and diagnostically challenging. We present the case of a 43-year-old woman who presented with prolonged fever, deep lymphadenopathy, massive splenomegaly, hepatomegaly, and severe hypercalcemia, mimicking malignancy. The diagnosis of sarcoidosis was established after the failure of anti-tubercular therapy, exclusion of differential diagnosis, and the subsequent development of cutaneous sarcoids. This case highlights the importance of recognizing isolated extrapulmonary pseudo-tumoral presentations of sarcoidosis, which can lead to delayed diagnosis.