Sarcoidosis is an idiopathic inflammatory granulomatous disorder that primarily affects the lungs. Abdominal manifestations without pulmonary involvement are infrequent. We present an atypical case of sarcoidosis in an elderly lady who presented with symptomatic hypercalcemia with computed tomography (CT) revealing multiple hepatosplenic hypodense granulomatous lesions with raised angiotensin-converting enzyme (ACE) levels. She had a good response to immunosuppressants. There is a rare possibility of isolated organ involvement without any pulmonary manifestation. Hence, ruling out other differentials and starting appropriate immunosuppressive treatment is necessary.
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