Surgical excision of a lobular capillary hemangioma of the upper lip after percutaneous embolization: A case report

Abstract

A 22-year-old male presented with a nodular subcutaneous lesion on the left upper lip. Ultrasound examination of the superficial tissues (Ecography) revealed a heterogeneously hyperechoic formation with small-caliber, high-flow vessels embedded in a probable adipose component. The suspected diagnosis was a hemangiomatous neoplasm. Given the lesion’s vascular nature and its location in a highly delicate area, a percutaneous embolization was performed prior to surgical excision to reduce intraoperative bleeding risk. Surgery was subsequently carried out without complications. Post-operative istopathological analysis confirmed the diagnosis of lobular capillary hemangioma (LCH), a benign vascular tumor that primarily affects the skin and mucous membranes. LCH is often associated with local trauma and is characterized by rapid growth, which may raise suspicion for malignancy. While surgical excision remains the definitive treatment, the vascular nature of the lesion poses a risk of significant hemorrhage, particularly in highly vascularized regions such as the face and oral cavity. This case highlights the importance of preoperative embolization as a valuable adjunct in the surgical management of LCH. By reducing blood flow to the lesion, embolization minimizes intraoperative bleeding, facilitates complete excision, and improves surgical outcomes. The use of this technique is particularly advantageous in challenging anatomical sites where excessive bleeding could complicate the procedure. Further studies are warranted to explore the broader applicability of embolization in the treatment of vascular tumors in sensitive regions.