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Sarcoidosis is a chronic granulomatous disease with multisystemic involvement with unspecified aetiology. Pancreatic involvement is a rare manifestation of systemic sarcoidosis and is often detected in postmortem studies. This clearly implies the rarity of the disease and its diagnostic challenges. Despite having various biochemical markers and imaging techniques, the only definitive method of diagnosis is the histological examination of the lesion. We present a patient with abdominal pain associated with obstructive jaundice, where imaging demonstrated features of pulmonary sarcoidosis along with a pancreatic head mass. Endoscopic ultrasound-guided biopsy demonstrated pancreatic non-caseating granulomas suggestive of sarcoidosis. Subsequently, the patient underwent biliary stenting and was started on glucocorticoid therapy., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Jayawickrama et al.)

Any mass lesion in the pancreas usually raises the possibility of undiagnosed pancreatic cancer. With the advancement of imaging modalities, we are seeing an increasing number of incidental findings, some of which may be clinically significant. When dealing with incidental pancreatic findings, it is critical to keep a broad differential in mind in addition to ruling out pancreatic malignancy. We present 3 rare cases of patients with 2 or more synchronous solid masses in the pancreas caused by pancreatic cancer, type 1 autoimmune pancreatitis, and sarcoidosis., (© 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.)