53-year-old woman diagnosed with tuberous sclerosis at the age of 29 due to the presence of multiple facial lesions (sebaceous adenoma). History of fibrocystic breast mastopathy and colloid goitre. Her parents and children showed no signs of the disease. She reported two palpebral lesions two years earlier that caused itching and tearing in the right eye. On examination, she presented multiple facial lesions with a butterfly wing distribution, flat in appearance, well demarcated (some overlapping), reddish and non desquamative, measuring approximately 0.4 to 0.8 cm in the longest axis. On the periungual area of both the fingers and toes there are fibromas (Koeman's tumours), and a hypopigmented patch on the chest. On the left lower eyelid there were two lesions affecting the free edge of the eyelid, nodular, cystic in appearance and yellowish-white in colour, located on the middle 1/3 and outer 1/3 of the eyelid, measuring 0.5 and 0.3 cm in diameter. The clinical diagnosis was epidermal inclusion cysts. The rest of the ophthalmological examination (ocular fundus) and systemic examination (cranial, thoracic and abdominal CT) were normal. Surgical treatment consisted of resection of the two palpebral tumours using two wedges that encompassed the lesions, with good cosmetic and functional results. The histopathological diagnosis was angiofibroma due to the presence of a pronounced collagenous proliferation associated with angiomatous hyperplasia. After 18 months of follow-up there was no evidence of recurrence.

