[[Intracranial]] [[capillary hemangioma]]s in [[adult]]s are rare, and [[diagnosis]] can be challenging. [[Hemangioma]]s, in general (and particularly in the skin), are more often noted in the [[pediatric]] [[population]]. Due to the lack of [[imaging]] undertaken in the presymptomatic [[phase]], the [[literature]] provides few clues on the rate of growth of these unusual [[tumor]]s. A 64-year-old man with a [[medical history]] of [[Lyme disease]] who presented with [[exhaustion]] and [[confusion]]. Imaging demonstrated an [[intraaxial]] [[lesion]] with vascularity in the posterior right [[temporal lobe]], raising the possibility of a [[glioma]]. Imaging two years prior revealed a very small [[lesion]] in the same [[location]]. The patient underwent a [[craniectomy]], total [[resection]] of the lesion was completed, and his [[symptom]]s of [[confusion]] resolved. [[Biopsy]] revealed a capillary hemangioma composed of small vascular channels lined by [[endothelial cell]]s and [[pericyte]]s without [[smooth muscle]]. Features of glioma, vascular [[neoplasm]]s or [[neuroborreliosis]] (cerebral Lyme disease) were not identified. The case documents the growth over two years of a rare intracranial capillary hemangioma in an older adult male ((MacLellan AD, Easton AS, Alubankudi R, Pickett GE. Documented growth of an [[intracranial capillary hemangioma]]: A case report. Neuropathology. 2023 Jul 4. doi: 10.1111/neup.12933. Epub ahead of print. PMID: 37403213.)).