Caruncular lobular capillary hemangioma in a child: Report of a rare ocular tumor

Caruncular lesions are uncommon because of the caruncle’s composite histology, making tumors in this region diagnostically challenging. Lobular capillary hemangioma, also termed pyogenic granuloma, is particularly rare in children. We report the case of a 6-year-old girl with a 3-month history of a painless, slowly enlarging, reddish swelling at the medial canthus of the left eye. Examination revealed a well-circumscribed, pedunculated vascular mass confined to the caruncle. The lesion was completely excised under general anesthesia. Histopathology revealed lobular proliferation of thin-walled capillary vessels lined by a flattened endothelium with inflammatory infiltrates and surface granulation tissue, without atypia or malignancy, confirming lobular capillary hemangioma. Postoperative recovery was uneventful and no recurrence was observed at a 6-month follow-up. This case underscores the rarity of caruncular hemangiomas in children, their potential to mimic other benign or malignant lesions, and the importance of histopathological examination for accurate diagnosis. Complete surgical excision provides both diagnosis and cure, with excellent cosmetic outcomes.