Sarcoidosis is a granulomatous disease that mostly affects the lungs and lymphatic system. When cervical lymphadenopathy is present, sarcoidosis can mimic metastatic head and neck cancer in imaging studies. Our patient had early-stage glottic cancer with lymphadenopathy at multiple sites, including the cervical region, which turned out to be sarcoidosis. We describe a rare case of sarcoidosis masquerading as metastatic glottic cancer and review the recent literature, highlighting the diagnostic dilemma in patients with malignancy who show hypermetabolic lesions on 18-fluorodeoxyglucose positron emission tomography/computed tomography. A biopsy for pathological examination is suggested to distinguish between cancer and sarcoidosis. (J Taiwan Otolaryngol Head Neck Surg 2022; 57:328-334)
