Capillary hemangioma of the caruncle: A case report and review of the literature.

PURPOSE: To describe a rare case of capillary hemangioma of the caruncle and to present a summary of previously published cases. OBSERVATIONS: A 59-year-old woman presented with a reddish, indurated mass of the left caruncle following minor ocular trauma. Slit-lamp examination revealed a well-defined vascular lesion measuring 6 × 6 mm without deep extension. Orbital imaging confirmed a circumscribed, superficial lesion. Histopathologic evaluation of the excised lesion demonstrated lobular proliferation of thin-walled capillary vessels within fibrous stroma, consistent with capillary hemangioma. The lesion showed partial spontaneous regression and no recurrence following complete excision.A comprehensive literature search of PubMed, Scopus, Embase, Web of Science, and Google Scholar (from inception to October 10, 2025) identified only a few histologically confirmed capillary hemangiomas of the caruncle. Most vascular lesions reported at this site were classified as pyogenic granuloma (lobular capillary hemangioma), emphasizing the exceptional rarity of true capillary hemangioma. CONCLUSIONS AND IMPORTANCE: Capillary hemangioma of the caruncle is exceedingly uncommon and may clinically mimic other vascular or inflammatory lesions. This case, together with the literature review, broadens the recognized clinicopathologic spectrum of caruncular vascular tumors and suggests that antecedent trauma may contribute to lesion development. Excisional biopsy remains the diagnostic and therapeutic gold standard.