Purpose : A case of a cleft lip complicated by a hemangioma involving a vermilion on the cleft side is very rare. We have experienced a three month-old boy with a left unilateral complete cleft lip, complicated by a vermilion hemangioma. The Operative design for cleft lip repair crossed the vermilion hemangioma. Decision of surgical management between a total excision of hemangioma and a desirable cleft lip repair had to be established. Materials and Methods : A three month-old boy with a left unilateral complete cleft lip and submucous cleft palate complicated by a hemangioma involving a vermilion on the cleft side. Moreover, multiple hemangiomas involved chin, right periauricular region, and left shoulder. The preoperative design using a small triangular flap for the cleft lip repair crossed the vermilion hemangioma. We focused more on the desirable cleft lip repair than the total excision of hemangioma on vermilion. The repair of the cleft lip was undertaken in accordance with the previously planned design. Results : The vermilion hemangioma was partially left behind while the cleft lip was repaired. No complications, such as postoperative ulceration and bleeding, were noted. The remaining hemangioma on vermilion did not influence the healing of the repaired cleft lip wound, and has almost involuted during next few years. As a result, the repaired cleft lip has shown satisfying shape and contour. The pathology report confirmed a capillary hemangioma. Multiple hemangiomas had almost involuted as in the case of the remaining hemangioma on vermilion. Conclusion : We suggest to conduct a desirable cleft lip repair rather than performing a excision of hemangioma in cases of modest hemangioma(no life-threatening bleeding) on a operative field for a cleft lip repair. We report this case as it may be considered as a management guideline for similar cases.

View Synopsis (.doc format, 376.0 kb)