Primary arteriovenous malformation of the eyelid mimicking a dermoid cyst: A case report

Figure 1 Preoperative clinical photograph showing left upper eyelid swelling. Frontal view of the patient demonstrating a well-defined swelling in the temporal aspect of the left upper eyelid, with normal overlying skin and no visible vascular changes such as discoloration or dilated vessels. The contralateral eye appears normal.

Figure 2 Histopathological features of the lesion (hematoxylin and eosin staining). A: Low-power view showing interconnected congested veins (black arrow) and empty spaces i.e., lymphatics (shown by star) [hematoxylin and eosin (H&E), × 2] suggestive of a combined veno-lymphatic malformation; B: Higher magnification demonstrating irregular, tortuous vessels lined by a single layer of endothelial lining (black arrow) (H&E, × 10).

Figure 3 Computed tomography of the orbits showing left upper eyelid lesion. Axial non-contrast computed tomography image demonstrating a well-defined soft tissue lesion in the left periorbital region (orange arrow) involving the upper eyelid and supraorbital area without evidence of underlying bony erosion or intraorbital extension. The imaging features were suggestive of a benign cystic lesion, such as an epidermal inclusion cyst.

Figure 4 Intraoperative photograph showing excision of the eyelid lesion. Intraoperative view of the left upper eyelid demonstrating a well-circumscribed vascular mass in the temporal region. The lesion is being carefully dissected from surrounding tissues, with visible vascularity and feeding channels. The specimen appears as a well-circumscribed, lobulated, reddish-brown soft tissue mass measuring approximately 2 cm in greatest dimension, consistent with a vascular lesion.

Figure 5 Postoperative clinical photograph showing resolution of the eyelid lesion. Frontal view of the patient demonstrating complete resolution of the swelling in the left upper eyelid following surgical excision, with well-healed surgical site and satisfactory cosmetic outcome at one year follow up. The contour of the eyelid appears normal with no evidence of recurrence.