Scar sarcoidosis developing 16 years after complete excision of an eyelid Basal carcinoma

A 56-year-old patient developed sarcoidosis on top of an old eyelid scar from previous removal of an eyelid basal cell carcinoma 16 years prior to presentation. An irregular, firm, ill-defined subcutaneous mass was palpable beneath an old minimally visible scar from the previous surgery. The patient had a strong family history of sarcoidosis and persistent dyspnea and cough for the past two years, which were only elicited after the histopathology results came out with multiple non-caseating granulomas with multi-nucleated giant cells. Sarcoidosis should be considered in the differential diagnosis of recurrent eyelid skin cancers especially if the external appearance or the duration after the initial surgery does not fit the criteria for recurrence.