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Lobular Capillary Hemangioma of the Eyelid Nikolas Raufi, B.A.*, Dale Meyer, M.D.*, and J. Andrew Carlson, M.D., F.R.C.P.C.† Departments of *Ophthalmology and †Pathology, Lions Eye Institute, Albany Medical Center, Albany, New York, U.S.A.

FIG. 1. Lobular capillary hemangioma of the eyelid.

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obular capillary hemangioma is a rapidly growing pedunculated or sessile mass notorious for profuse bleeding on manipulation. Despite its common occurrence, lobular capillary hemangioma remains elusive and is correctly diagnosed in only 28% and 42% of cases, based on 2 studies. A 72 yearold man was originally diagnosed with chalazion by his ophthalmologist weeks after debris struck his eyelid (Fig. 1A). Visual impedance by the lesion led to excision excluding the eyelid margin allowing for a simple reconstructive procedure (Fig. 1B,C). This lesion’s location was atypical as most

lobular capillary hemangioma of the ocular adnexa originates from the palpebral conjunctiva and not from the skin.1 On histologic examination with hematoxylin and eosin stain, mature lobular capillary hemangioma exhibits a fibrous stroma that separates lobules of capillaries (Fig. 1D). This lobular architecture with superficial dilated capillaries surrounded by plump pericytes is essential for making the diagnosis and accounts for the lesion’s propensity to bleed (Fig. 1E,F). At 2 weeks follow up, the man is doing well and has had no recurrence (Fig. 1C).

Accepted for publication July 26, 2014. The authors have no financial or conflicts of interest to disclose. Address correspondence and reprint requests to Nikolas Raufi, B.A., 43 New Scotland Avenue, Albany, NY 12208. E-mail: [email protected] DOI: 10.1097/IOP.0000000000000311

Ophthal Plast Reconstr Surg, Vol. 31, No. 2, 2015

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Lobular capillary hemangioma of the eyelid.

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