Mandibular Arteriovenous Malformation In Pregnancy

Abstract

Benign vascular lesions, such as hemangiomas of childhood, arteriovenous malformations (AVMs) and venous malformations, are uncommon and have been found in a variety of organs throughout the body. Vascular lesions of bone are found most often in the vertebral column. Vascular tumors of the mandible are rare. We report a case of a mandibular AVM found in a pregnant woman at 35 weeks' gestation. A pregnant woman presented at 35 weeks' gestation with right-sided jaw pain and was found to have a pulsatile mass on the internal surface of the right mandible in the area of the premolars. Profuse bleeding of the lesion required emergent selective arterial embolization of a vascular tumor of the mandible, which resulted in successful occlusion of the vessels. Uncomplicated vaginal delivery followed induction of labor. Excision and reconstructive surgery occurred 1 week postembolization. Pathology confirmed an AVM. Mandibular AVMs are rare vascular tumors that, when correctly diagnosed, can be successfully managed during pregnancy. Whether or not vascular or hormonal changes associated with pregnancy can exacerbate a preexisting AVM is debatable.

Delivery by Cesarean Section after Embolization for Vaginal Arteriovenous Malformation

“…In contrast, the view of Sholapurkar et al [5] was that asymptomatic cases should be left alone because embolization is risky and possibly unnecessary. Moreover, arterial embolization is not always successful because of the multiple feeding vessels and the size of the arteries to be embolized [6] .…”

Rupture of splenic arteriovenous malformation in pregnancy: a rare case with maternal and fetal survival

“…Rupture of intracranial arteriovenous malformations are the most common of the vascular catastrophies in pregnancy and account for 4.4% of all maternal deaths (Newton and Bell, 1995). Pulmonary (Jacobi et al, 2001), uterine , renal (Saito et al, 1987), mandibular (McMahon et al, 1997) and digital (McCulley et al, 1997) arteriovenous malformations complicated by pregnancy have been reported in the literature. Rupture of splenic arterio-venous malformation mimics rupture of splenic artery aneurysm, which has a maternal mortality of 75% and 95% fetal loss (Shahabi et al, 2000).…”

Embolization of vascular malformations

“…This classification satisfies therapeutic, but not histopathological requirements [3]. It is known that different stimuli, such as accidents, pregnancies or puberty, can cause exacerbation of VMs, thereby making diseases that have been clinically silent for years to suddenly require therapy [5]. In our current times, vessel ligatures and proximal occlusions of feeding arteries should be made obsolete, since, as a rule, such treatments tend to lead to severe, mostly unmanageable recurrences -a fact that was made known back in 1925 by authors like Reid [4] and Berenstein et al in the present [6].…”