Intravascular lobular capillary hemangioma of the temporal artery arising in an older adult: a case report.

Purpose: To describe a case of an intravascular lobular capillary hemangioma arising in the temporal artery of an older patient. Observation: Lobular capillary hemangiomas (LCHs) are common benign vascular tumors previously described in literature as arising in the skin and mucous membranes of children and young adults. They have very rarely been characterized as arising from the temporal artery or being present in older adults. This report details the case of a 60-year-old man with reported history of intermittent blurry vision and jaw pain, headaches, and fatigue with bilateral shoulder and neck pain. He subsequently developed a palpable, tender left temple mass over the course of three weeks. Ultrasound of the left forehead over the lesion identified focal outpouching of a blood vessel with a thickened wall and arterial flow. Biopsy of the lesion, initially intended to rule out vasculitis, demonstrated numerous capillaries amidst a fibromyxoid stroma with immunohistochemical staining confirming it as an LCH. The first reported case of an intravascular lobular capillary hemangioma (IVLCH) of the temporal artery involved a 27-year-old man in 1994; this was, followed by a second report of a 47-year-old man in 2022, both of which were confirmed via biopsy. Conclusion: This is a reported case of a temporal artery IVLCH in an older patient. This contributes to limited literature characterizing unusual IVLCH variants, and while rare, can be considered in the differential for temporal artery pathology and superficial temporal masses.