Recurrent Cutaneous Myxoma of the Eyelid: A Case Report

Cutaneous myxomas are rare, benign mesenchymal tumors of the dermis. They may occur in isolation or as part of genetic syndromes and can affect the head and neck regions, yet eyelid involvement is rare. We report a case of a 24-year-old male with a 10-year history of a recurrent right upper eyelid lesion, previously excised five times. Clinical examination revealed a pearly, nodular lesion, and histological findings of dermal fibroplasia and dilated vessels, initially misdiagnosed as a hemangioma. Subsequent recurrence and excisional biopsy showed hypocellular myxoid stroma with embedded spindled cells, confirming the diagnosis of cutaneous myxoma. Systemic evaluation excluded syndromic associations such as cardiac myxoma. The patient remained recurrence-free at 3 months postoperatively. Early-onset disease, multiple recurrences, and unusual location emphasize the need for careful clinicopathologic correlation and long-term follow-up. Recognition of this rare entity is critical for appropriate management, exclusion of systemic associations, and reduction of recurrence risk. This case highlights that recurrent eyelid lesions, even when previously diagnosed as benign vascular lesions, should prompt reconsideration of rare myxoid tumors.