Multidisciplinary Approach to Facial Hemangioma: Systematic Review and Case Report

Abstract

Facial hemangiomas are benign vascular tumors that represent a clinical entity of significant interest due to their biological behavior, diverse clinical presentation, and potential functional and aesthetic implications. Although most hemangiomas are diagnosed during infancy, these lesions may also occur in adulthood, where they typically present as slowly progressive vascular masses. Their location on the face and scalp is particularly relevant because of the cosmetic impact they may produce and their proximity to anatomically and functionally important structures.

We present the case of a 35-year-old female patient with a hemangioma located in the left frontal region, characterized by progressive growth and occasional episodes of bleeding. Initial clinical evaluation suggested a benign vascular lesion; however, imaging studies were essential to determine its anatomical extent and establish the most appropriate therapeutic plan. Computed tomography (CT) revealed a superficial lesion confined to the subcutaneous tissue, without evidence of infiltration into deep structures, periosteum, or frontal bone, findings that favored a conservative surgical approach.

The literature review demonstrated that the management of facial hemangiomas should be individualized according to the clinical characteristics of the lesion, patient age, symptomatology, and the degree of aesthetic or functional impairment. Although several therapeutic alternatives exist, including observation, pharmacological treatment, laser therapy, and sclerotherapy, surgical excision remains a highly effective option for superficial, well-circumscribed lesions amenable to primary closure.

In the present case, the absence of deep extension allowed complete surgical resection while preserving the surrounding tissues. The surgical defect was reconstructed using layered primary closure, resulting in a satisfactory postoperative course without complications or clinical recurrence during follow-up. Histopathological examination confirmed the diagnosis of superficial capillary hemangioma, corroborating the preoperative clinical suspicion.

The findings of this case are consistent with current scientific evidence, which indicates that careful clinical evaluation complemented by imaging studies enables accurate selection of patients who are candidates for surgical treatment. Complete excision offers several advantages, including immediate lesion resolution, histopathological confirmation of diagnosis, low recurrence rates, and favorable cosmetic outcomes when primary closure is feasible.

In conclusion, superficial facial hemangiomas in adult patients can be successfully treated through surgical excision when appropriate patient selection is performed. Preoperative evaluation using computed tomography is essential to exclude deep tissue involvement and optimize surgical planning. Surgery represents a safe, effective, and definitive treatment option capable of providing excellent functional and cosmetic outcomes with minimal morbidity, as demonstrated in the present case.