Background: Focal myositis is a benign, self-limited and rare inflammatory disease of skeletal muscle, which presents as a soft tissue pseudotumor frequently mimicking a sarcoma or an abscess, involving any part of the body.Case Report: We present a 37-year-old man with a short history of a non-painful pseudotumor like swelling in bilateral thigh region. MRI studies showed hypertrophy of the anterior thigh muscles, electromyography was consistent with evidence of a focal myopathy in the rectus femoris muscles, and muscle biopsy revealed the characteristic non-caseating granulomatous myositis consistent with sarcoidosis. The patient was successfully treated with methotrexate.Conclusions: The frequency of methotrexate treatment in focal nodular sarcoid myositis is unclear from the literature, our patient is the first reported successfully treated with methotrexate.

Keywords: myositis, sarcoidosis, granulomatous