Aggressive glabellar angiomyxoma with orbital extension

A 62-year-old male presented with a large non-tender mass in the glabella, extending into the right orbit that had been steadily growing for 6 months. Imaging revealed a 2.5 x 1.8 cm cystic mass with extension into the right anterior orbit. Biopsy with microscopic examination revealed a predominantly myxoid stroma containing spindle-shaped cells with bipolar cigar-shaped nuclei and small caliber capillary-type vascular proliferations. These findings are consistent with an angiomyxoma. Although angiomyxomas typically present in the pelvic region or peritoneum in female patients, there have been rare examples of angiomyxomas with orbital involvement.