Cutaneous hamartoma overlying the frontal bone – a rare paediatric case report

Abstract

Hamartomas are benign malformations composed of disorganized mature tissues native to their site of origin. Their occurrence in the supraorbital region is extremely rare and may mimic inflammatory or neoplastic lesions, leading to diagnostic challenges, particularly in paediatric patients. Aim of the study was to report a rare case of a supraorbital cutaneous hamartoma in a child, outlining the clinical features, diagnostic evaluation, surgical management, and histopathological confirmation. An 11-year-old female presented with a 9-month history of a tender, mobile swelling over the left supraorbital region. Clinical examination, ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI), and routine laboratory investigations were performed. The lesion was excised surgically under general anaesthesia, and the specimen was sent for histopathological evaluation. Ultrasonography revealed a hypoechoic collection; CT identified a soft tissue swelling with a calcific fragment, while MRI showed mild local oedema without intracranial extension. Surgical excision revealed a cystic lesion containing a bony fragment. Histopathology demonstrated fibro adipose, fibromuscular, and fibro-collagenous tissues with vascular and neural bundles, confirming a hamartoma. The postoperative course was uneventful, with no recurrence noted at 4-week follow-up. Supraorbital cutaneous hamartomas are exceedingly rare in paediatric patients and may clinically resemble other benign or inflammatory lesions. A combination of imaging and histopathology is essential for accurate diagnosis. Complete surgical excision is curative and prevents recurrence. Long-term follow-up is advisable to monitor for late recurrence or syndromic associations.