A case of pelvic arteriovenous malformation in a male

Tanaka, Michio; Iida, Katsuyuki; Matsumoto, Shinichi; Takeuchi, Takumi; Yamaguchi, Kazumi; Nishimura, Yuichi; Tominaga, Takashi

doi:10.1046/j.1442-2042.1999.00077.x

Cited by 10 publications

(8 citation statements)

References 12 publications

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“…In gray-scale imaging, a lesion can be seen to have a multicystic pattern or tortuous anechoic tubular structures [ 9 , 10 ]. Color Doppler imaging is useful in showing the lesion’s vascular origin and in showing the high velocity – low resistance flow in vessels that feed and drain AVM [ 9 , 11 ]. CT angiography shows tortuous enlarged vascular structures typically associated with pelvic veins in the pelvic area [ 7 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

Giant Congenital Pelvic AVM Causing Cardiac Failure, Diplegia, and Neurogenic Bladder

et al. 2015

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SummaryBackgroundPelvic arteriovenous malformations (AVMs) are uncommon lesions and only a rare number of male cases have been reported. Their clinical presentations are variable and imaging modalities have an important place in diagnosis and treatment planning.Case ReportWe present the imaging findings of a giant congenital pelvic AVM that was diagnosed in a 30-year-old male patient eight years ago and which progressed despite follow-up and treatment, causing cardiac failure, diplegia, and neurogenic bladder.ConclusionsPelvic AVMs are uncommon lesions and they can present with various symptoms based on their locations and sizes. Delays in the diagnosis and treatment can cause local and systemic complications. Imaging is very important in the diagnosis of pelvic AVM.

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Section: Discussionmentioning

confidence: 99%

Giant Congenital Pelvic AVM Causing Cardiac Failure, Diplegia, and Neurogenic Bladder

et al. 2015

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“…Presentations of pelvic AVM in males can be either subtle or dramatic, and patients have presented with pelvic and flank abdominal pain, 3 painless gross hematuria, 4 hemotospermia, 5 urinary frequency, ureteric obstruction and massive bleeding during transurethral resection of the prostate with a diagnosis of prostate hyperplasia. 6 The AVM in this case was discovered during routine examinations for dysuria, such as a rectal examination and transrectal US.…”

Section: Discussionmentioning

confidence: 99%

Pelvic congenital arteriovenous malformation diagnosed by transrectal ultrasonography: A case report

Suzuki

Tanaka

Ebine

et al. 2012

CUAJ

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Arteriovenous malformations (AVMs) of the pelvis are relatively rare and difficult to treat because of multiple and extensive feeding vessels. We report the case of a 69-year-old male with pelvic congenital AVM that was detected during tests for dysuria. He visited our hospital complaining of voiding difficulty. Digital rectal examination revealed a pulsating mass that was palpable on the right side of the prostate. Transrectal ultrasonography showed multiple hypoechoic lesions adjacent to the prostate and colour Doppler ultrasonography revealed the flow regions corresponded to the hypoechoic lesions. Computed tomography demonstrated large-to-small tubular vessels adjacent to the prostate, while pelvic angiography showed many small feeder arteries extending mainly from the right internal iliac artery. He was diagnosed as having pelvic congenital AVM. Uroflowmetry revealed slight voiding difficulty without residual urine. The patient decided against treatment and requested we monitor his clinical course. IntroductionArteriovenous malformations (AVMs) of the pelvis are relatively rare, usually congenital lesions, and are difficult to treat because of multiple and extensive feeding vessels.1 Selective angiography of the iliac arteries is still the best method for diagnosing pelvic AVM, although the usefulness of computed tomography (CT) has also been recognized.Transrectal ultrasonography (US) is one test used in the routine evaluation of dysuria in male patients, and can assist with ruling out diseases, such as prostate cancer and benign hyperplasia. We describe a patient with congenital pelvic AVM who complained of voiding difficulty, and we also discuss the use of transrectal US to diagnose pelvic AVM. Case reportA 69-year-old male visited our hospital with the chief complaint of voiding difficulty, which has persisted for more than 12 months. He was taking medications for dysuria, including an alpha-1 blocker, which had been prescribed by another doctor. There was no history of abdominal or pelvic trauma or surgery.Rectal examination revealed a normal-sized prostate; however, a pulsating mass was palpable on the right side. Transrectal US showed a normal image and normal prostate size (prostate volume was 16.8 cm 3 ); however, multiple hypoechoic lesions with a heterogenous sonographic pattern were located adjacent to the prostate. Colour Doppler US demonstrated flow regions, with a light colour in the same lesions ( Fig. 1). Routine laboratory values and urine analysis were normal. The serum prostate specific antigen (PSA) level was normal (0.52 ng/mL). We suspected congenital pelvic AVM and performed a pelvic enhanced CT.Pelvic CT showed large to small tubular vessels adjacent to the prostate, and AVM and aneurysmal changes were observed mainly on the right side of the pelvis (Fig. 2, Fig. 3). Pelvic angiography revealed a large AVM being supplied mainly by the right internal iliac artery (Fig. 4). Many small feeder vessels, including from the left internal iliac artery, that drained directly into th...

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“…Recently, many cases undergo transcatheter arterial embolization because hemorrhaging can be controlled and local and regional complications can be stabilized. 4,5,6,8 However, if elimination of the nidus is unsuccessful or if the symptoms have not improved after embolization, further intervention is necessary. Due to the difficulty of surgical resection, an alternative consisting of intra-operative embolization of the venous compartment under control of feeding and draining vessels may an effective method.…”

Section: Case Reportmentioning

confidence: 99%

“…At the patient's request, we monitored his clinical course without further intervention. Presentations of pelvic AVM in males can be either subtle or dramatic, and patients have presented with pelvic and flank abdominal pain, 3 painless gross hematuria, 4 hemotospermia, 5 urinary frequency, ureteric obstruction and massive bleeding during transurethral resection of the prostate with a diagnosis of prostate hyperplasia. 6 The AVM in this case was discovered during routine examinations for dysuria, such as a rectal examination and transrectal US.…”

Section: Case Reportmentioning

confidence: 99%

Pelvic congenital arteriovenous malformation diagnosed by transrectal ultrasonography: A case report

Suzuki¹,

Tanaka²,

Ebine³

et al. 2012

cuaj

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A case of pelvic arteriovenous malformation in a male

Cited by 10 publications

References 12 publications

Giant Congenital Pelvic AVM Causing Cardiac Failure, Diplegia, and Neurogenic Bladder

Giant Congenital Pelvic AVM Causing Cardiac Failure, Diplegia, and Neurogenic Bladder

Pelvic congenital arteriovenous malformation diagnosed by transrectal ultrasonography: A case report

Pelvic congenital arteriovenous malformation diagnosed by transrectal ultrasonography: A case report

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