A 29-year-old woman presented with an unusual lesion on the right auricular antihelix. The mass was purple and painful, and it had been present for 17 years. Preoperatively, the presumptive diagnosis was a venous malformation. The mass was resected, and a staged reconstruction was performed. Microscopic analysis of the specimen revealed that the lesion was an angioleiomyoma. Most cases of angioleiomyoma involve the extremities; few have been described in the head and neck region, and very few of those have been reported on the ear. Among those auricular angioleiomyomas that have been reported, most were distinctly painless. We report a new, atypical case of this unusual tumor.
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