Arteriovenous malformation (AVM) are caused by failure of
primitive arteriovenous channels to regress during fetal development.
Extracranial AVM is a rare entity. The aim of this descriptive study is to show
the progressiveness of an extracranial AVM of a patient over the course of 20
years. A 34 years old male, initially presented with a soft compressible at the
left ear pinna since age of 15 years old. 6 years later he developed another
soft compressible swelling at the left cheek. Further investigations showed
arteriovenous malformation from branches of the left external carotid artery
with draining veins from left external jugular vein. A suggested treatment of
embolization and left pinectomy made the patient worried of disfigurement and
he defaulted treatment from Hospital Kuala Lumpur. Last year he had one
presentation of blood spurting from his left ear pinna which needed medical
attention at Hospital Shah Alam. CT Angiography (CTA) was done and the extent
of the disease recorded which involved the terminal branches of external
carotid artery for the external ear AVM, which are maxillary artery and
superficial temporal artery as well as facial artery for the submandibular AVM,
all draining into the external jugular vein. Currently there are more protruding
vessels seen at the back of his ear and he was advised to revisit Hospital
Kuala Lumpur for treatment option. It is a sign of persistence and
progressiveness of his disease. Author was unable to find reported incidence of
external ear and submandibular AVM in the same individual, however there was a
reported case of infratemporal and parotid AVM. The affected branches were
different however it shows there are literature of more than 1 extracranial AVM
on the same side but scarce. Follow up of this patient may provide useful in
monitoring further vessel dilatation or new AVM cranially or caudally from the
branches of the external carotid artery.
Author(s) Details:
Shanthi Mariapan,
Shah Alam Hospital, KKM, Malaysia.
Sangaran Gopal,
Lincoln
University, Malaysia.
Ruchi Negi,
Tengku Ampuan Rahimah Hospital, Klang, Malaysia.
Fatin Haziqah,
Tengku Ampuan Rahimah Hospital, Klang, Malaysia.
Dinie Tumaisuri,
Shah Alam Hospital, Malaysia.
Please see the link here: https://stm.bookpi.org/NVMMS-V7/article/view/14258
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