Small lymphangiomas of the eyelids

Three patients are described with focal lymphangiomatous lesions of their eyelids. A child with a partially regressed, congenital lesion presented with evidence of recent hemorrhage, while, of two adults with acquired tumors, one had a blue lesion suggesting a malignant melanoma, and the other had a more obviously cystic lesion, suggesting an epidermal or adnexal cyst. In one case, the lesion was situated entirely within the marginal orbicularis striated muscle, and in the other two cases the lesion was restricted to the dermis of the lid. Abrupt change in the coloration of a lesion in the lid should suggest hemorrhage into a preexistent tumor. Hemorrhage into lymphangiomas is extremely common, and therefore this vascular tumor should be included in the differential diagnosis of previously nondiscolored lesions. Other vascular tumors, such as capillary, cavernous or venous angiomas would be expected to have a longstanding reddish-blue hue.