Sarcoidosis is a multisystemic granulomatous disease of unknown cause. The skin and lungs are the most commonly affected organs. In addition to the classic lesions of cutaneous sarcoidosis including a wide range of elementary dermatological lesions, mass involvement is not common. A 43-year-old male was admitted to the orthopedic clinic with a mass growing on the right hand and wrist. A tru-cut biopsy from the lesion yielded granulomatous inflammation. However, the index finger of the patient was amputated as the mass enlarged and caused loss of function in the finger, and malignancy, especially desmoid tumor, couldn’t be ruled out because a solid, infiltrative mass with a diffuse pattern extending from the second finger to the wrist were characterized in magnetic resonance imaging. Histopathological examination of the amputated tissue yielded non-caseating granulomatous inflammation without acid-fast bacilli, and negative for malignancy. The patient was referred to our clinic after this stage, and diagnosed with sarcoidosis with multiorgan involvement. As local progressions developed further despite methyleprednisolone therapy, a second surgical excision was performed, and the patient required second-line immunosuppressive for the disease to be controlled. Mass is not an expected cutaneous manifestation of sarcoidosis. This case of suspected malignancy due to a hard mass in the right hand and wrist, which led to amputation, shows that a benign condition can become aggressive enough to cause tissue loss. When unusual involvement occurs in benign conditions such as sarcoidosis, a multidisciplinary, comprehensive approach should be used to plan treatment decisions before invasive procedures are undertaken.