Acquired eyelid capillary hemangioma in a young adult: Clinical, surgical, and histopathological correlation

Acquired capillary hemangioma (ACH) of the eyelid is a rare benign vascular tumor that differs from the more common infantile form and is infrequently reported in adolescents and adults. An 18-year-old female presented with a painless, slow-growing mass in the central preseptal region of the right upper eyelid, located above the eyelid crease, with a duration of nine years. On examination, the lesion measured 2 × 1.5 cm and was firm, non-compressible, and non-pulsatile. Best-corrected visual acuity was 6/6 in both eyes preoperatively. Ultrasonography demonstrated a heterogeneous hypoechoic subcutaneous lesion with punctate vascular flow and no evidence of deep extension. Complete surgical excision was carried out using monopolar cutting diathermy (8–10 W, cutting mode, needle electrode). Intraoperatively, superficial fibers of the orbicularis oculi muscle were found to be involved and were excised along with the lesion. The wound was closed with interrupted 6-0 Vicryl sutures for the deep layer and 6-0 nylon for the skin, which was removed at two weeks. Histopathological examination confirmed the diagnosis of acquired capillary hemangioma. Postoperatively, visual acuity remained 6/6, the cosmetic outcome was excellent, and no recurrence was noted at six months of follow-up. ACH, although uncommon in adolescence, should be included in the differential diagnosis of eyelid masses, and complete surgical excision offers definitive management with favorable cosmetic results and minimal risk of recurrence.