Ophthalmology Research: An International Journal

Background: Capillary haemangioma is a benign vascular tumour characterised by proliferation of capillary-sized blood vessels and is most commonly encountered during infancy and early childhood. Presentation involving the eyelid during adolescence is uncommon and may create diagnostic difficulty because it can resemble other vascular or neoplastic lesions.

Case Presentation: A 14-year-old male presented with a progressively enlarging swelling of the left upper eyelid for 2 months. Examination showed a solitary, reddish, sessile growth measuring approximately 3 cm × 3 cm. The lesion was firm, rubbery, non-compressible, non-pulsatile, and increased in size during the Valsalva manoeuvre. No associated ocular abnormality, regional lymphadenopathy, or other vascular lesion was identified. Surgical excision was performed. Intraoperatively, the lesion had an indistinct capsule, and increased bleeding was encountered during dissection. Histopathological examination demonstrated a benign vascular neoplasm composed of lobular proliferation of capillary-sized vascular channels separated by fibrocollagenous connective tissue. The capillaries were lined by round-to-oval endothelial cells with bland nuclear morphology, without nuclear atypia, pleomorphism, or mitotic activity. These findings confirmed capillary haemangioma. The postoperative course was uneventful, and no recurrence was observed during follow-up.

Conclusion: Capillary haemangioma should be considered in the differential diagnosis of progressive eyelid masses even beyond the typical infantile age group. Histopathological examination is important for definitive diagnosis, and complete excision can provide effective management for a localised lesion.