Abstract
A 53-year-old right-hand-dominant man presented with a recurrent, painful mass localized to the volar surface of the right small finger, leading to discomfort and impaired function. Radiographic imaging was unremarkable for osseous involvement. Surgical excision followed by histopathological and immunohistochemical (IHC) analysis established the diagnosis of angioleiomyoma, marked by desmin-positive smooth muscle fibers and CD34-positive vasculature. Given its infrequency in the hand and overlap with more common benign lesions, angioleiomyoma remains diagnostically elusive. This report emphasizes the pivotal role of tissue-based diagnostics and supports excision as a definitive treatment modality.