An Unusual Case of Medial Canthal Angioleiomyoma

An 84-year-old Caucasian male was referred for evaluation of a worsening left medial canthal lesion for consideration of excision. The patient reported a 4-year history of the painless canthal lesion gradually increasing in size with progressively obstructed peripheral vision. On examination, the cream-colored cyst measured 10 × 8 mm. The best-corrected visual acuity with glasses was 6/7.5-2 in the right eye and 6/7.5 in the left eye with intraocular pressure of 10 mm Hg bilaterally. The lesion was excised under local anesthetic. Histopathology confirmed a cutaneous angioleiomyoma with adipocytic metaplasia. The postoperative course was uneventful, with a planned 3-month review for surveillance of recurrence.