Recurrence of testicular tumors in young males generally prompts rapid investigation and treatment. We report 3 patients with past histories of treated testicular cancer referred with radiographic evidence suggestive of intrathoracic metastases. In each case chest imaging demonstrated mediastinal/hilar lymphadenopathy. In one case pulmonary nodules were also identified. In all three patients further work-up revealed non-caseating granulomas consistent with sarcoidosis. All patients have since been followed and remain free of testicular cancer. No patient has required therapy for sarcoidosis. Although rare, new intra-thoracic lymphadenopathy in previously treated testicular cancer patients can represent sarcoidosis. Tissue diagnosis is essential when the clinical picture remains unclear.

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