A 50-year-old male presented with a one-month history of foreign-body sensation in his left eye. The initial examination revealed an erythematous, vascularized, pedunculated lesion arising from the left eye conjunctiva. A tissue biopsy from the lesion confirmed the diagnosis of an AFX with a small component of squamous cell carcinoma. The patient was intermittently lost to follow-up until, one-and-a-half years after his initial visit, he underwent an exenteration of the left eye as the tumor had intraocular and extraocular muscle extensions. Subsequently, he was scheduled for ongoing monitoring.