From the Research
I strongly recommend proceeding with the excision of the benign hemangioma in this 50-year-old male patient during today's visit, as the most recent and highest quality study 1 supports the safety and feasibility of removal under local anesthesia. Since the biopsy has already confirmed the benign nature of the mass, complete surgical removal is appropriate. The procedure will involve local anesthesia (typically 1-2% lidocaine with epinephrine), careful dissection around the hemangioma to avoid excessive bleeding, complete excision with a small margin of normal tissue, and closure with appropriate sutures.
Post-procedure care should include:
- Keeping the wound clean and dry for 24-48 hours
- Antibiotic ointment application for 3-5 days
- Suture removal in 7-14 days depending on the location The patient should be advised to watch for signs of infection (increasing pain, redness, warmth, drainage) or recurrence. Hemangiomas are benign vascular tumors composed of abnormal blood vessels, and complete excision is typically curative with low recurrence rates, as supported by a study on surgical treatment of hemangiomas of soft tissue 2. The procedure is generally well-tolerated with good cosmetic outcomes when performed properly, and the use of local anesthesia has been shown to be safe and effective in young children 1, which can be extrapolated to adults.
It is essential to note that while other studies discuss the management of hemangiomas in different contexts, such as airway management 3 and embolization for bleeding 4, these are not directly relevant to the current case of a benign hemangioma in a 50-year-old male patient. Additionally, a review of hepatic hemangiomas 5 highlights the importance of indications for surgery, but this is not applicable to the current case. Therefore, based on the most recent and highest quality evidence, proceeding with the excision of the benign hemangioma under local anesthesia is the recommended course of action.