Uterine arteriovenous malformation treated by hysteroscopic excision

Abstract

Uterine arteriovenous malformation (AVM) is a vascular hamartoma of the myometrium that mostly results from uterine tissue damage. Herein, we report a case of uterine AVM managed successfully by hysteroscopy. The patient had an induced abortion and subsequent persistent vaginal spotting and irregular active vaginal bleeding. Ultrasonography showed a 3.5 cm × 2.9 cm heterogeneous lesion in the endometrial cavity with increased vascularity. Symptoms were monitored without uterine artery embolization to avoid complications that may affect a future pregnancy. However, 10 days later, she presented with active vaginal bleeding. Hysteroscopic endometrial mass excision was performed. Her postoperative hemoglobin level and vital signs were stable. Biopsy of the excised mass revealed AVM. Her postoperative vaginal bleeding decreased significantly, and outpatient ultrasonography 1 month later showed no abnormal findings. This case confirms the feasibility and safety of hysteroscopic management of uterine AVMs. The hysteroscopic technique should be prioritized for managing uterine AVMs.

Persistent Ectopic Pregnancy Mimicking Uterine Arteriovenous Malformation: A Case Report

“…When conservative treatments fail, for women who have already nished their birth plan, a hysterectomy remains the common recommendation (10). Fertility-preserving surgeries such as laparoscopy and hysteroscopy often are reported as case reports (11,12). In our case, medications and surgeries were tried.…”

Uterine Arteriovenous Malformation: A Pictorial Review of Diagnosis and Management

“…65 A Foley catheter can work to stem the bleeding in the situation of lifethreatening hemorrhage. 66 Patients with minor bleeding and stable hemodynamic status can receive conservative treatment. Many of these patients will have no symptoms, suggesting that the microlesion UAVM resolves on its own.…”

“…32 The scheme of diagnostic and treatment are shown in Figure15. 19,21,[44][45][46][47][48][63][64][65][66][67][68][69][70]…”

“…82,83 One proposed hypothesis is that endothelial dysfunction that produces AVM is caused by increased activity of the kinase MAP2K1, also known as MEK1. MEK1 inhibitors are used in cancer 19,21,[44][45][46][47][48][63][64][65][66][67][68][69][70] meandering vessels in the myometrium and parametrium. The uterine wall is also slightly thick.…”

“…Figure 15.Approach to diagnosis and treatment of uterine arteriovenous malformation (UAVM) 19,21,[44][45][46][47][48][63][64][65][66][67][68][69][70]. …”