Figure 1- The extra-oral view of the patient. Diffuse swelling of the lips and redness of skin around the lips is visible.

The intraoral examination consisted of a multi-lobular exophytic lesion in the left buccal mucosa with a smooth surface, rubbery consistency, and normal color.

After intra-oral and extra-oral examination, due to the redness and swelling of the lips, OFG was the initial diagnosis. To verify this diagnosis, other local and systemic factors must be ruled out, and the first step, is a biopsy test.

The macroscopic results of the biopsy examination were as followed: soft tissue with elastic consistency and grayish color of the mucous membrane. Microscopic results showed granulomatous inflammation with bundles of histocytes that were surrounded by a lymphocytic rim, with foreign body giant cells, and asteroid body with stellate inclusions. Hence, the diagnosis turned out to be Sarcoidosis.

Later on, a serum Angiotensin-converting enzyme level test (ACE) and chest x-ray were done. The laboratory results showed a reasonably high ACE level (78 IU/L) and a slightly higher than normal ESR level (25 mm/h), which supported the diagnosis of sarcoidosis.