Systemic sarcoidosis is an autoimmune disease with a prevalence of 40 per 100,000 people and which mostly affects young adults. It is characterized by non-caseous granulomatous changes of interstitial tissue, predominantly in the lungs. Extrapulmonal sarcoidosis has been described in every organ, but is present only in 1-5% with pancreatic involvement. Furthermore, sarcoidosis leading to a symptomatic mass in the pancreas is extremely rare and must then be differentiated in particular from cancer and pancreatitis. For therapy, it is crucial to find the right diagnosis before planning an operation--otherwise overtreatment by surgery may be an unwanted consecution.