A Case of Recurrent Conjunctival Vascular Lesion in a Young Adult: A Clinicopathological Challenge

Conjunctival vascular tumours are rare in adults and often pose diagnostic challenges due to overlapping features between haemangioma and lymphangioma. A 22-year-old male presented with painless, slowly enlarging mass in the left lower lid for five years. The lesion was excised in July 2021, and histopathology revealed conjunctival haemangioma. However, a residual mass remained and gradually increased in size, reaching 2.5×1 cm. A second excision was performed in July 2025, and histopathological examination demonstrated dilated vascular and lymphatic channels consistent with conjunctival lymphangioma. Postoperative course so far is uneventful and the patient remains recurrence free on three months follow-up. This case illustrates the diagnostic dilemma of conjunctival vascular tumours, especially when histopathological features vary between excisions. Recurrence may be related to incomplete excision or the co-existence of vascular and lymphatic components. Careful excision, histopathological confirmation, and long-term follow-up are essential as conjunctival vascular tumours are known for their recurrences. Recurrent conjunctival vascular lesions in adults require thorough evaluation, as haemangioma and lymphangioma may co-exist or mimic one another.