Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 3 2023 05 14 191 193 EN Donia Chebbi Department of Internal Medicine, Hedi Chaker University Hospital, Medical School of Sfax, University of Sfax, Sfax, Tunisia Raida Ben Salah Department of Internal Medicine, Hedi Chaker University Hospital, Medical School of Sfax, University of Sfax, Sfax, Tunisia Faten Frikha Department of Internal Medicine, Hedi Chaker University Hospital, Medical School of Sfax, University of Sfax, Sfax, Tunisia Hela Fourati Department of radiology, Hedi Chaker university hospital, Sfax Mariem Ghribi Department of Internal Medicine, Hedi Chaker University Hospital, Medical School of Sfax, University of Sfax, Sfax, Tunisia Zeineb Mnif Department of Internal Medicine, Hedi Chaker University Hospital, Medical School of Sfax, University of Sfax, Sfax, Tunisia Zouhir Bahloul Department of Internal Medicine, Hedi Chaker University Hospital, Medical School of Sfax, University of Sfax, Sfax, Tunisia 2021 01 17 2023 01 21 Sarcoidosis is a systemic disease histologically characterized by the presence of non-caseating granulomas. Granulomas can affect all structures of the body, giving heterogeneous manifestations and making the diagnosis of this disease a real challenge. We report the case of a 72-year-old woman who presented with two rare manifestations of sarcoidosis: an orbital and a pulmonary pseudotumor. The orbital tumor revealed the disease. Clinically, the patient had palpebral swelling. Orbital MRI showed an orbital pseudotumor hypointense on T1, and hyperintense on T2, heterogeneous and enhanced after gadolinium injection. The thoracic localization was asymptomatic, revealed by the chest Computed Tomography (CT) scan. Histological evidence of granuloma was obtained at both locations. The level of angiotensin-converting enzyme was high. All the other systemic granulomatous diseases were eliminated. We started a systemic corticotherapy with good clinical results. https://acta.tums.ac.ir/index.php/acta/article/view/9097 https://acta.tums.ac.ir/index.php/acta/article/download/9097/5764