Case report of a successful multidisciplinary approach to a giant scrotal malformation

Scrotal arteriovenous malformation (AVM) successfully resected without angioembolization: A case report

“…Duplex Ultrasonography (DUS) was most frequently used as a diagnostic method to describe the characteristics of the vascular lesion and help in differentiate its nature [ 4 ]. Digital Subtraction Angiography (DSA) was also a favorable method to establish definitive diagnosis, identify the feeding vessels, and assess the anatomical pattern of the lesion in more detail particularly when using endovascular treatment [ 5 ]. In addition, Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) were helpful in establishing the diagnosis in some cases, but not in choosing the therapeutic strategy [ 1 , 3 ].…”

Scrotal arteriovenous malformation: Case report

“…Scrotal AVM are extremely rare, representing less than 1% of vascular neoformations, making them difficult to diagnose and to find adequate treatment [ 4 , 6 ]. For their diagnosis, the physical exam should be taken into account, as well as evaluation of scrotal inflammation, pain, and history of hemorrhages [7] .…”

“…In this case, the patient was submitted to all 3. Sclerotherapy has the function of reducing the size of venous nidus; embolization is performed before surgical resection to facilitate the procedure with minimum risk of bleeding [ 2 , 4 ], although it is also used as a permanent treatment [8] . Finally, surgery is the definitive, recommended treatment [8] ; however, it presents some complications, as malformations tend to be extended and poorly defined [1] .…”

“…Vascular lesions are rare conditions little described in medical literature, which may mention varicocele, hemangioma, lymphangioma and arteriovenous malformations [1] . Among them all, arteriovenous malformations (AVM) are the least common [ [2] , [3] , [4] , [5] ]. Their areas of frequent appearance are the throat, limbs, trunk sites, intracranial and extracranial [6] ; therefore, it is said that AVM in the scrotal region are the most rare [ 1 , [6] , [7] , [8] ].…”

“…AVM are present from birth, produced by alterations in the morphogenesis of the vessels [9] , and grow proportionately to the growth of the child [ 6 , 9 ]. They are characterized by large feeding vessels, hypervascularity and excess of arteriovenous connections at the nidus level [10] ; they may be asymptomatic or present growth in size, bleeding, pain or azoospermia [ 1 , 8 ], and cause infertility, heart failure, and even fatal hemorrhages [ 4 , 11 ].…”