Congenital hemangiomas in rare anatomical sites: A report of two pediatric cases and literature review

Congenital hemangiomas (CHs) are rare benign vascular tumors that are fully developed at birth and distinct from infantile hemangiomas in their biology and natural history. Although typically localized to the head, neck, and extremities, CHs occurring in unusual anatomical sites or presenting with functional impairment remain a clinical challenge. We describe two pediatric cases of congenital hemangioma in rare anatomical regions. A 5-year-old female with a giant CH of the right gluteal and knee regions, complicated by recurrent ulceration, bleeding, infection, and transfusion-dependent anemia. A staged surgical excision (knee, then gluteal) was performed, followed by six months of propranolol. At one-year follow-up, she remains complication-free. A 3-year-old female with a congenital hemangioma of the lower lip and oral mucosa, noted at birth, presenting with feeding difficulty but no bleeding or infection. Clinical and imaging findings confirmed a high-flow lesion without deep extension. Surgical excision was performed and the child recovered uneventfully. Congenital hemangiomas in uncommon anatomical sites may present with significant complications or functional impairment. Staged or definitive surgical excision, supplemented by propranolol therapy when indicated, provides excellent outcomes.