A 76-year-old Caucasian woman presented with a caruncle tumour, histologically diagnosed as mixed adenosquamous carcinoma. Complete excision was performed, but this necessitated removing parts of the lacrimal canaliculi. No local recurrence or distant metastasis was found after six months' follow-up, and spontaneous recanalisation of both canaliculi occurred. This tumour is believed to be a primary adenosquamous carcinoma of the caruncle and possibly the first reported case. Long term follow up is planned to detect late metastasis, but complete excision of the tumour and its favourable site should yield a good prognosis.