[Unilateral lachrymal gland enlargement revealing sarcoidosis in an 85-year-old man]

We present a case of an 85-year-old Caribbean man initially presenting with lachrymal gland enlargement and a large subcutaneous extension responsible for a hemifacial "lion-like" deformation. The most important diagnoses to suggest are adenocarcinoma of the lachrymal gland, lymphoma, leprosy, tuberculosis, and sarcoidosis. Based on the clinical, biological, and radiological findings, sarcoidosis was suspected with lachrymal gland and pulmonary lesions. Biopsy of the enlarged lachrymal gland revealed a non caseating granuloma compatible with the diagnosis of sarcoidosis. The value of this case is the atypical field and sarcoidosis revealed as a unilateral lesion in an elderly male.