Background: Bilateral lower extremity edema may serve as an early clinical manifestation of pulmonary sarcoidosis. Identifying sarcoidosis as the underlying cause can be challenging in patients with or without a prior history of the disease, as lower extremity edema is not typically considered part of its clinical spectrum.
Case Report: A 63-year-old man presented with a complex medical history, including non-Hodgkin lymphoma, bilateral renal cell carcinoma, colon cancer, and pleomorphic sarcoma of the upper extremity. He also had a history of recurrent pulmonary sarcoidosis. He reported a 6-month history of bilateral pitting lower extremity edema that developed several months before the onset of dyspnea.
Conclusion: In patients with multiple comorbidities, recognizing sarcoidosis as a potential cause of bilateral lower extremity edema requires careful exclusion of systemic and malignant etiologies. Sarcoidosis should be considered when more common causes have been excluded.