Epiphora as a presenting sign of angioleiomyoma of the lacrimal sac

A 50-year-old man presented with progressive enlargement of a right medial canthal mass for 5 years. The patient subsequently noted epiphora of 6-month duration on the affected side. An anterior orbitotomy was performed, which uncovered a well-circumscribed mass in the lacrimal sac. Histologic sections of the mass revealed an angioleiomyoma. Following complete excision, the epiphora resolved and there is no evidence of tumor recurrence at 1 year of follow-up. To the best of our knowledge, this is the first report of an angioleiomyoma in the lacrimal sac.