To report the presentation and management of an atypical and advanced case of nodular hidradenoma of the eyelid with ptosis.

A 64-year-old woman who presented with a palpable growing nodular mass and ptosis was tested with marginal reflex distance 1 as right eye 1 mm, left eye -1.5 mm and levator function test as 12 mm and 10 mm, respectively during a hospital visit. The patient was tentatively diagnosed with eyelid adnexal tumor with mechanical ptosis and was managed by surgical excision of the lesion. Histology confirmed hidradenoma.

Hidradenomas are benign adnexal tumors originating from the eccrine gland and rarely detectable in the eyelid. However, rudimentary glandular structures can be a possible tumor source. Nodular hidradenoma should be considered in the differential diagnosis of adnexal masses and such lesions may cause significant functional and cosmetic morbidity despite their histologically benign nature.