Phalange osteolysis present as the initial manifestation of sarcoidosis in a young female.

Benign nonneoplastic conditions can often mimic bone tumors in imaging studies, leading to diagnostic challenges. We report the case of a young female who presented with osteolysis of the left ring finger and mediastinal lymphadenopathy as initial manifestations. Initially misdiagnosed with a bone tumor, she underwent surgery performed by an orthopedist. Histopathological analysis of the phalanges revealed granulomatous inflammation without necrosis. Further examination of subcarinal lymphadenopathy revealed similar histological findings. Ultimately, the patient was diagnosed with sarcoidosis involving the left ring finger and the mediastinal lymph nodes. Sarcoidosis should be considered in adult patients with bone involvement. Differentiating between neoplastic and nonneoplastic conditions requires a thorough assessment of the medical history of the patient, imaging studies, and pathological findings.