A case of arteriovenous malformation in the buccal region

Arteriovenous malformation (AVM) in the maxillofacial region is a rare, but potentially life-thereatening vascular lesion. Although AVM is usually diagnosed on angiography, the procedure is very invasive. We report the identification of AVM and feeding vessels on three-dimensional CT angiography (3D-CTA), which is minimally invasive.A 21-year-old man with a right buccal swelling was referred to our hospital. AVM was diagnosed on the basis of clinical signs and examinations such as ultrasonography, MR imaging, MR angiography, and CT. Angiography was not done. The vascular lesion was fed by two arteries (facial artery and infraorbital artery) in the right buccal region, clearly demonstrated on 3D-CTA. The patient underwent resection of the lesion and simultaneous reconstruction with a local flap. There was no evidence of recurrence 6 months after surgery.Three-dimensional CTA can identify feeding vessels and assess the extent of AVM. This method is useful for surgical planning, as well as preoperative diagnosis.

[1]  K. Tominaga,et al.  Three-dimensional identification of hemangiomas and feeding arteries in the head and neck region using combined phase-contrast MR angiography and fast asymmetric spin-echo sequences. , 2005, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[2]  Jianguang Wang,et al.  Comprehensive treatment of arteriovenous malformations in the oral and maxillofacial region. , 2005, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[3]  R. Sze,et al.  Three-dimensional CT angiography imaging of vascular tumors of the head and neck. , 2005, International journal of pediatric otorhinolaryngology.

[4]  近藤 昭二,et al.  咬筋内 High Flow AVM (arteriovenous malformation) の1例 , 2001 .

[5]  J. Mulliken,et al.  Arteriovenous Malformations of the Head and Neck: Natural History and Management , 1998, Plastic and Reconstructive Surgery.

[6]  J. Mulliken,et al.  Arteriovenous Malformations of the Head and Neck: Natural History and Management , 1998, Plastic and reconstructive surgery.

[7]  O. Enjolras Classification and Management of the Various Superficial Vascular Anomalies: Hemangiomas and Vascular Malformations , 1997, The Journal of dermatology.

[8]  M S van Leeuwen,et al.  CT angiography: application to the evaluation of carotid artery stenosis. , 1993, Radiology.

[9]  K. Hussain,et al.  Hemangiomas, Vascular Malformations, and Lymphovenous Malformations: Classification and Methods of Treatment , 1993, Plastic and reconstructive surgery.

[10]  A. Stavros,et al.  MR imaging of symptomatic peripheral vascular malformations. , 1992, AJR. American journal of roentgenology.

[11]  J. Glowacki,et al.  Hemangiomas and Vascular Malformations in Infants and Children: A Classification Based on Endothelial Characteristics , 1982, Plastic and reconstructive surgery.

[12]  J. Merland,et al.  Embolization by superselective arteriography from the femoral route in neuroradiology review of 60 cases , 1973, Neuroradiology.

[13]  M. Wakoh,et al.  Three-dimensional volumetric visualization of arteriovenous malformation of the maxilla. , 2003, Dento maxillo facial radiology.