Isolated fibromas of the ocular adnexa are rare. Fibromas of the tendon sheath (FTS) are benign, collagenous, spindle cell neoplasms that typically present as an acquired, painless mass in the adult extremities. They infrequently involve the head and neck. We report a case of FTS presenting as a medial canthal mass. Like most FTS, the lesion in our patient was successfully treated by complete surgical excision. While the differential diagnosis contains a variety of mesenchymal tumors, the clinical and radiographic characteristics should lead to the correct diagnosis. To our knowledge, this is the first case of FTS reported to arise at this site.
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