Hypercalcaemia can be the only initial symptom of sarcoidosis.

Sarcoidosis is an ordinary systemic inflammatory disease that can affect many organs. It is characterized by development of non-necrotizing granulomas. It commonly affects lungs (80%) while hypercalcaemia is found in 5% and reflects an activation of T-cells within the granulomas that causes an overproduction of 1,25-dihydroxyvitamin D3. We describe a case where hypercalcaemia was the only symptom in a patient with extrapulmonary sarcoidosis, and the investigation was misled by different serologic findings though PET-CT showed fludeoxyglucose uptake in the biceps femoris muscles. The diagnosis was made after a biopsy.