Purpose

To describe the clinical presentation and management of a patient with a congenital, slowly progressive upper eyelid mass causing severe mechanical ptosis and visual disturbance, and to highlight the diagnostic challenges associated with vascular eyelid lesions.

---

Methods

A 31-year-old woman presented with a long-standing, compressible bluish mass over the medial left upper eyelid that enlarged with Valsalva maneuver. MRI demonstrated a well-defined multilobulated lesion confined to the eyelid without orbital extension. Doppler ultrasonography showed predominantly venous flow with areas of low-resistance arterial signals. Complete surgical excision with eyelid reconstruction was performed, and the specimen was submitted for histopathologic evaluation.

---

Results

The excised specimen consisted of gray-to-dark, soft, irregular vascular tissue. Histopathology revealed dilated, thin-walled vascular channels lined by flattened endothelial cells consistent with a cavernous venous malformation. At 10 months post-operatively, the patient showed resolution of mechanical ptosis, good eyelid contour, and no evidence of recurrence.

---

Conclusion

Isolated eyelid cavernous venous malformation is an uncommon entity, with only a few cases reported in the literature. Clinical features and imaging findings may mimic distensible venous malformations or arteriovenous malformations. Imaging alone may not reliably distinguish vascular subtypes; therefore, histopathologic confirmation remains the diagnostic gold standard. Complete surgical excision allows histopathologic confirmation and effective functional rehabilitation.

---

Additional Authors

First name	Last name	Base Hospital / Institution
Mariel Angelou	Parulan	Quirino Memorial Medical Center

↑ Back to top